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PREPARED BY:
DR.RAHUL PATEL
   M.D.S. PART 1
CONTENTS
   Introduction
   Review of literature
   Definition
   Requirements of cast
   Requirements of die preparation
   Ideal requirements of die material
   Materials
   Methods
   Bibliography
INTRODUCTION
                       Direct fabrication of patterns for
              extracoronal restorations in the mouth is
              inconvenient, difficult, time consuming,
              and virtually impossible. A cast and die
              system captures the necessary
              information so that it can be transferred
              to the laboratory.




Rosensteil (2001) Contemporary Fixed Prosthodontics 3rd edition Mosby
REVIEW OF LITERATURE
    James Stackhouse (1970) conducted a study concerning the
     accuracy of stone dies affected by the dimensional changes
     in rubber impressions
      They concluded that
1.    More uniform dies were produced from silicon
2.    One silicone material was more significant than the others
3.    Perforated tray technique caused the dies to be undersized
      in diameter
4.    Bench setting caused the stone dies to be shorter in length
      and thicker in diameter
    Gerald T Nomura et al(1980) evaluated the accuracy, fit,
     detail registration and Knoop hardness of 3 commercially
     available resin die systems
They concluded :
1.    Complete crown epoxy resin dies are undersized
2.    MOD onlay epoxy resin dies are accurate
3.    Detail duplication of epoxy resin dies is comparable to die
      stone
4.    Hardness values of epoxy resin are less than those of
      stone
   Myers M., Hembree J.H.(1982) – conducted a
    study on the relative accuracy of four removable
    die systems.      4 die systems were studied i.e.
    the brass dowel pin, the Plastipin, the J-pin, &
    Logix Model System & they determined the vertical
    shift & the horizontal shift of the dies.
      They concluded that Plastipin exhibited least
    amount of horizontal shift & the brass dowel pin
    exhibited greatest shift in both directions.
DEFINITION
   MODEL : “A MODEL IS A REPLICA OF A
    TEETH AND THE ASSOCIATED
    SUPPORTING BONY TISSUE OF A
    JAW,WHICH IS PREPARED FROM AN
    IMPRESSION.”

   DIE : “A POSITIVE REPRODUCTION OF
    PREPARED TEETH AND CONSISTS OF A
    SUITABLE HARD SUBSTANCE OF A
    SUFFICIENT ACCURACY.”
REQUIREMENTS OF THE
      CAST
            Accurate surface detail

            Free of voids.

            Precise articulation.

            Soft tissue should be reproduced


Rosensteil (2001) Contemporary Fixed Prosthodontics 3rd edition Mosby
REQUIREMENTS FOR THE
      DIE PREPARATION
            Reproduce the prepared tooth exactly.

            No bubbles or void

            The remaining unprepared tooth structure
             immediately cervical to the finish line
             should be 0.5 to 1mm visible.

            Adequate access to the margin is
             imperative.

Rosensteil (2001) Contemporary Fixed Prosthodontics 3rd edition Mosby
IDEAL REQUIREMENTS FOR
      DIE MATERIAL
              Accurate


              Dimensionally stable


              Setting expansion and contraction, variations in
               response to change in temperature need to be
               minimum


              It should reproduce the fine details

Rosensteil (2001) Contemporary Fixed Prosthodontics 3rd edition Mosby
         Strong and durable


            Withstand the carving and finishing procedures


            The color should contrast that of the wax to ease the
             manipulation


            Economical


            Easy to use




Rosensteil (2001) Contemporary Fixed Prosthodontics 3rd edition Mosby
MATERIALS
            It includes :
               Gypsum
                          Type1-Impression Plaster
                          Type2-Model Plaster
                          Type3-Dental Stone
                          Type4-Dental Stone(High strength)
                          Type5 –Dental Stone(High strength and high expansion)
               Resin
                        Epoxy Resin
                        Polyurathane
               Electroplated Dies
                        Copper plated
                        Silver plated
               Flexible Die Materials
               Amalgam used die material
               Metal sprayed die



Rosensteil (2001) Contemporary Fixed Prosthodontics 3rd edition Mosby
GYPSUM
             Gypsum(CaSO4.2H2O) is a mineral mined
              product used extensively in dentistry to
              make dental models.
               In its unrefined state, gypsum is the dihydrate
                   form of calcium sulfate.
             Model plaster
               Commonly called plaster of Paris, is used
                   primarily for pouring preliminary impressions
                   and the making of diagnostic models.
             Dental stone
               For use as a working model when a more
                   durable diagnostic cast is required.



Philips (1992) Science of dental materials 11th edition W.B Saunders
-
       Die Stone, High Strength (Type IV):

        •α-hemihydrate of the “Densite” type.
        •Cuboidal shaped particles & reduced surface area produce
        such properties without undue thickening of mix.
        •W/P ratio – 0.22 – 0.24
        •Setting time - 12±4min.
        •2hr Setting Expansion – Maxi. 0.10%
        •1hr compressive strength – 5000psi.




Philips (1992) Science of dental materials 11th edition W.B Saunders
Die Stone, High Strength, High Expansion (Type
   V)
  Higher compressive strength than Type IV.
  Setting Expansion – 0.10% - 0.30%.
  W/P ratio – 0.18 – 0.22
  Setting time - 12±4min.
  1hr compressive strength – 7000psi.



 GYPSUM HARDENER



Philips (1992) Science of dental materials 11th edition W.B Saunders
RESINS

      EPOXY RESIN


           Used effectively with rubber based impression materials
           available in the form of a paste to which an activator is
            added to initiate hardening
           Care should be taken that the activator not come in
            contact with the skin as it is toxic



Philips (1992) Science of dental materials 11th edition W.B Saunders
PROPERTIES
             Working time -15min
             Setting time 1 to 12 hours depending on the products
             Compressive strength after 7days is 16,000psi
             Abrasion resistance is superior to stone dies
             Dimensional change due to shrinkage during
              polymerization is between 0.03% to 0.3% and continues
              to occur for up to 3 days
             Epoxy resin are very viscous when pored hence
              porosity can occur




Philips (1992) Science of dental materials 11th edition W.B Saunders
         Advantages
       1.        More resistant to abrasion
       2.        Dimensionally stable

                Disadvantage
       1.        The epoxy resin cannot be readily introduced into
                 the details of a large impression as dental stone
                 and requires a centrifugal machine for the same
       2.        It shrinks by about 0.1to 0.2% in about 24 hours
       3.        It is expensive



Philips (1992) Science of dental materials 11th edition W.B Saunders
ELECTROPLATED DIES
        Electroplated dies are the ones that are produced
         when an impression material is electroplated
        When a die is made in this manner this process is
         known as electroforming
        The impression materials which can be
         electroplated are impression compound and
         elastomeric materials
        The types of dies are-
         - Copper plated dies
         - Silver plated dies
        The popularity of copper plated dies began in the
         early 1930’s

Philips (1992) Science of dental materials 11th edition W.B Saunders
ADVANTAGES

             No dimensional changes occur during electro

              deposition of a metal

             It reproduces the impression accurately

             The die is tough and has good strength characteristics




Philips (1992) Science of dental materials 11th edition W.B Saunders
COPPER PLATED DIES
        Impression compound is usually copper plated
        The impression material is the cathode and it is
         connected to the anode which is made of
         electrolytically pure copper and is immersed in the
         plating solution so that the area of copper
         immersed is approximately equal to that of the
         impression to be plated
        COMPOSITION OF SOLUTION FOR
         COPPERPLATING BATHS
         Copper Sulphate (crystals) - 200gms
         H2SO4 (conc)                 - 30ml
         Phenol Sulfonic Acid        - 2ml
         Water Distilled              - 1000ml


Philips (1992) Science of dental materials 11th edition W.B Saunders
TECHNIQUE
 The surface of the impression is coated with a conductor of
  electricity such as graphite, copper powder, silver before it
  is attached to the cathode lead wire. This process is known
  as “metalizing”. This determines the surface character of
  the finished die

     The copper sulphate is the source of copper, the sulphuric
      acid increases the conductivity and phenol sulfonic acid
      helps to assist the penetration of the copper crystals into
      the deeper parts of the impression

     Initially 15 ma current is given which can later be increased
      to 2 to 3 times the initial current

     The plating is allowed to proceed for 12 to 15 hours (usually
      overnight)

Philips (1992) Science of dental materials 11th edition W.B Saunders
SILVERPLATED DIES
       Silver plating is done over rubber based
        impression materials
       Silver plated dies show more vertical change than
        stone dies, the difference being between 0.25% to
        0.45% depending on the impression material
        , while the horizontal changes are not significant
       COMPOSITION OF THE SOLUTION
        Silver cyanide          - 36gm
        Potassium cyanide - 60gm
        Potassium carbonate - 45gm
        Water (distilled)       -1000ml




Silver plated dies marginal accuracy of cast restorations J Prosth Dent 51;1984: 768-772
Technique
         The impression is first made conductive by
          brushing the surface with powdered silver
         A current of 5ma is suitable to start plating a
          single tooth impression and 10 ma for larger
          areas
         Once a layer of silver is deposited the
          current can be doubled or trebled
         Time period is usually 12 to 15 hours


Silver plated dies marginal accuracy of cast restorations J Prosth Dent 51;1984: 768-772
FLEXIBLE DIE MATERIALS
             They are similar to heavy bodied silicone or
              polyether impression materials
             Selection of a compatible die and impression
              material is very important in case of flexible dies
             Advantages over die stone
               Rapid setting

               Ease to removal




Comparision of surface detail reproduction of flexible die materials J Prosth Dent 1998; 80:485-9
AMALGAM DIES
             Model amalgam is similar to silver amalgam which
              is used for fillings
             It is used to make hard metal dies which
              reproduce fine details and sharp margins from
              impression compound of prepared teeth
             They cannot be made in hydrocolloid impressions
              as they cannot withstand condensation pressure
             After packing the impression with amalgam the die
              can be removed after a minimum of 12 hours, by
              gently warming the compound


Philips (1992) Science of dental materials 11th edition W.B Saunders
      As amalgam is a good conductor of heat
             , softened wax applied to them cools rapidly

            This may produce internal stresses which
             may distort the wax pattern after removal
             from the die

            Sudden cooling of the wax may also result in
             contraction of the wax away from the die

            A separating agent is needed as with die
             stone

Philips (1992) Science of dental materials 11th edition W.B Saunders
METAL SPRAYED DIES
             A bismuth – tin alloy which melts at 138oCcan be
              sprayed directly on to an impression to form a metal
              shell which can than be filled with dental stone

             A metal coated die can be obtained rapidly from
              elastomeric impression material

             Disadvantage the alloy is soft care is needed to
              prevent abrasion of the die



Philips (1992) Science of dental materials 11th edition W.B Saunders
CAST & DIE SYSTEMS

         1) Working cast with removable die
                          i.   Straight dowel pin
                         ii.   Curved dowel pin
                        iii.   Di-lok tray
                        iv.   Pindex system
         2) Working cast with separate die
         3) DVA model system
         4) Zeiser model system

Shillenberg (1981) Fundamentals of fixed prosthodontics 3rd edition Quintessence
STRAIGHT DOWEL PIN
        The brass dowel pin is one of the most
         accurate dowel types in terms of
         resisting horizontal displacement and
         the second lowest in vertical deviation of
         four types of removable dies.
        A dowel pin is positioned over each
         prepared tooth in the impression.
        Place a dowel between
        the arms of a bobby.

Shillenberg (1981) Fundamentals of fixed prosthodontics 3rd edition Quintessence
     Push a straight pin between the arms of the
           bobby pin and into the impression material on
           both the buccal and the lingual surfaces of
           each tooth to have a dowel pin placed over it.

          Stabilize the dowel in the bobby pin.

          Pour die stone into the impression, filling the
           impressions of the teeth and covering the
           knurled end of the dowel pin.

          The pin should parallel the long axis of the
           preparation.
Shillenberg (1981) Fundamentals of fixed prosthodontics 3rd edition Quintessence
    When the stone is hard and dry, use a
        saw frame with a thin blade




                                                                    There should be a cut on the
                                                             mesial and distal side of each die,
                                                             and the cuts should taper toward
                                                             each other slightly from
                                                             occlusal to gingival.

     Take the die form the cast and trim away excess stone gingival to
      the finish line.
     Complete the trimming of the die with a no.25 blade in the
      laboratory knife and then mark the finish line with the red pencil.
     Repeat the procedure for each die on the cast.



Shillenberg (1981) Fundamentals of fixed prosthodontics 3rd edition Quintessence
CURVED DOWEL PIN
              To install pin before pouring the impression, use finger
               pressure to insert tip of dowel into large opening of
               position bar.
              Hold the bar faciolingually, so that head of the dowel is
               1-2mm into the proposed area of impression.
              The tail of dowel extends facially; however if the tooth
               is linguoversion, turn it towards lingual side for easy
               removal.




Shillenberg (1981) Fundamentals of fixed prosthodontics 3rd edition Quintessence
     Insert a straight pin into one of 3 holes into the facial
       aspect of bar and into the facial flange of impression and
       another pin into lingual flange through lingual holes of bar.
      The dowel should not touch the impression and its head
       should be parallel to long axis of prepared tooth or teeth.
      This procedure is repeated for all abutments and pontic
       areas.
      One pin is placed near the center of each segment of
       unprepared teeth, this wall help in removal of segment for
       better access of gingival wax pattern.
      Impression is poured with die stone until it covers heads of
       dowel. This will fill the impression about 4 mm above
       gingival finish line.
      The straight pins and positioning bar are removed as soon
       as stone is set.

Shillenberg (1981) Fundamentals of fixed prosthodontics 3rd edition Quintessence
To assist in orienting each large segments
     of unprepared teeth, cut a 2mm deep hole
     on either side of each dowel with a large
     acrylic bur.




                                                                     Petrolatum is applied on stone and also an
                                                                     exposed part of dowel for easy separation
                                                                     from the base.




Shillenberg (1981) Fundamentals of fixed prosthodontics 3rd edition Quintessence
•Impression is boxed, allowing the tails of
                                                  the dowels to extend slightly through the
                                                  heat softened wax.




•Fill the boxed impression with dental stone. The dowel should be covered by at
least 2mm of stone.


         •After the stone has hardened, make vertical
         saw cuts on either side of each die.




                                                                                   •A die is removed by
                                                                                   pressing the dowel



Shillenberg (1981) Fundamentals of fixed prosthodontics 3rd edition Quintessence
TO PLACE THE DOWELS AFTER THE
   CAST HAS BEEN MADE.
   •Pour the impression with die stone to form
   a horseshoe shaped working cast.
   •Trim the bottom of cast flat to level 10mm
   from the necks of teeth.This is done
   because thin cast are easy to saw and
   short dowels are more stable than larger
   ones.




                                                  •Drill a 5mm deep hole in the bottom of the
                                                  cast directly under the center of each
                                                  prepared tooth, pontic area, and segment
                                                  containing unprepared teeth.
                                                  •This can be made with 2mm diameter drill
                                                  in hand piece or drill press.




Shillenberg (1981) Fundamentals of fixed prosthodontics 3rd edition Quintessence
•Clean the dowel holes, insert the curved
           dowel pin properly and then adjusted for
           proper fit.
           •Cement the dowels into holes one at time
           with placing a drop of cyanoacrylate
           cement into each hole.




                                                         •The head of a curved dowel is seated into the
                                                         holes.




•Seat the heads completely with tail pointing facially.
•Then same procedure of pouring base and preparing dies
is repeated

Shillenberg (1981) Fundamentals of fixed prosthodontics 3rd edition Quintessence
PINDEX SYSTEM(Coltene/Whaledent,Mahwah,NJ)


        In the pindex system a reverse drill
         press is used to create a master cast
         with dies that can be removed and
         replaced repeatedly with great precision.
        The impression is poured without
         positioning and attaching dowel pins
         beforehand.
        The machine accurately drills parallel
         holes from the underside of trimmed
         cast.

Shillenberg (1981) Fundamentals of fixed prosthodontics 3rd edition Quintessence
PINDEX SYSTEM




                                 Diagram showing the pindex machine


Shillenberg (1981) Fundamentals of fixed prosthodontics 3rd edition Quintessence
•Pour the impression, adding approximately
                 20mm of stone.
                 •Wet the cast prior to trimming




                                                                       •Then trim the bottom of the cast, resting
                                                                       the heels on the table of the trimmer.




    •It should sit perfectly flat on a
    tabletop, and its thickness must be a
    minimum of 15mm.



Shillenberg (1981) Fundamentals of fixed prosthodontics 3rd edition Quintessence
•Periphery of the cast should be trimmed.




                                                           •Remove any excess stone in the
                                                           palate/tongue area with an arbor band on a
                                                           lathe.
                                                           •The lingual border of the cast should taper
                                                           slightly toward the base to facilitate
                                                           removal of the dies from the cast later.
                                                           •The faciolingual width -20mm.




             •Use a pencil mark the desired location of
             the pins on the occlusal surfaces of the
             teeth or preparations.

Shillenberg (1981) Fundamentals of fixed prosthodontics 3rd edition Quintessence
•Place the prepared cast on the worktable and
                                                      align the first pencil mark with the illuminated
                                                      dot from the light beam director.
                                                      •Using both hands, exert firm downwards
                                                      pressure on the cast with thumbs.
                                                      •Raise the handle bar with slow, even pressure
                                                      and the drill assembly moves upwards cutting
                                                      the pinholes.
                                                      •When proper depth is achieved, red light goes
                                                      off.
                                                      •Same procedure is repeated with each mark.
                                                      •For better results, cast is made slightly damp
                                                      to prevent dust formation.




Shillenberg (1981) Fundamentals of fixed prosthodontics 3rd edition Quintessence
•Compressed air and brush is used to
                                              remove debris from holes.




             The pin holes are refined with hand reamer.



                                            •Cyanoacrylate cement is placed on the pins prior to
                                            cementing the pin tips.




           •Shorter pins are placed before the long
           pins in lingual or palatal holes and long
           pins in the facial holes.

Shillenberg (1981) Fundamentals of fixed prosthodontics 3rd edition Quintessence
•White sleeves are placed on the long pins and gray
                                     sleeves on the short pins.




                    •The bottom of the cast is lightly coated with
                    the petrolatum.


                                    •Gray sleeves are blocked with small
                                    amount of molten wax to prevent the
                                    sleeve from filling with stone when
                                    secondary base is added.




       •Strip of utility wax along the ends of the long pins
       to facilitate removal of the dies later.


Shillenberg (1981) Fundamentals of fixed prosthodontics 3rd edition Quintessence
•A palatal or tongue filler is made of boxing wax.




                    •The filler is seated to the cast.




                                           •Boxing wax is applied aaround the cast.




              •Base is poured with the die stone.




Shillenberg (1981) Fundamentals of fixed prosthodontics 3rd edition Quintessence
•When stone becomes hard, the cast is seated in the
                                  base former.



           •Saw cuts are premarked with the pencil.




                                          •Then dies are sectioned from the underside.




           •It may also be sectioned from the occlusal
           aspect.




Shillenberg (1981) Fundamentals of fixed prosthodontics 3rd edition Quintessence
     After the die are sectioned, trim them in a
           conventional manner.

          Mark the finish line with red pencil.

          Apply die hardener and die spacer.

          Then place the completed cast on the
           articulator and then cast is ready for
           fabrication of the wax pattern.


Shillenberg (1981) Fundamentals of fixed prosthodontics 3rd edition Quintessence
DI-LOK TRAY SYSTEM
            A snap apart plastic tray with internal orienting
             grooves and notches is used to reassemble
             working cast and dies.




Shillenberg (1981) Fundamentals of fixed prosthodontics 3rd edition Quintessence
TECHNIQUE
            The cast should be poured in a U shape, with no stone
             in the center building it up to 2.5cm. (1.0 inch)
            A lingual side of the cast base is trimmed with an arbor
             band.


            Horizontal grooves are cut in the base to for retention.


          When stone has set for 1 hr, separate it from impression.
        Cast is trimmed in horseshoe configuration to fit in Di-lok
       tray and the buccal border is tapered towards base with
       arbor band.



Shillenberg (1981) Fundamentals of fixed prosthodontics 3rd edition Quintessence
     Soak the base of cast with water for 5
      min.
     Pour the base in tray, until ¾ of its is
      filled
     Seat the cast on tray; in such a way that
      cervical line of the prepared teeth should
      be approximately 4mm above the level
      of base.
     Wipe off the excess stone.
     Allow the stone to set until it is hard and
      dry .
     To complete the dies, the cast must be
      removed from the tray.




Shillenberg (1981) Fundamentals of fixed prosthodontics 3rd edition Quintessence
•Disassemble the tray by lifting the back
                                             up, and then slide the buccal segment
                                             forward.



                               •Then with a saw frame and a thin saw blade,
                               cut between the prepared tooth and the
                               adjacent tooth.
                               •The saw cut should start in the interdental
                               papilla area and extend downward on a very
                               slight taper.
                               •The occlusal saw cut should extend three-
                               quarters of the way through the stone base.



                                                  •Use finger pressure to break the die and
                                                  attached teeth from the cast.


Shillenberg (1981) Fundamentals of fixed prosthodontics 3rd edition Quintessence
•Remove excess stone gingival to the
              finish line with a pear-shaped acrylic bur.




                                             •Then cast and dies are
                                             reassembled in the tray.




      •Then the cast and tray mounted on the
      articulator.




     •When the stone has set, the articulated cast in the Di-lok tray is
     ready for the fabrication of the wax pattern.

Shillenberg (1981) Fundamentals of fixed prosthodontics 3rd edition Quintessence
WORKING CAST WITH
      SEPARATE DIE(MULTI-POUR
      TECHNIQUE)
            ADVANTAGES
               Simple
               Slightly more accurate.
               Minimum trimming.
            DISADVANTAGES
               Difficult to transfer complex or fragile wax
                patterns from cast to die.
               Seating the pattern on the cast may be
                problematic.
               Technique can be used with elastomeric
                impression materials.


Rosensteil (2001) Contemporary Fixed Prosthodontics 3rd edition Mosby
 The area of preparation is poured with
       the stones in small increments.
      When set,it is separated.A second pour
       is then made of the entire arch.

             •The first pour which is more accurate is
             trimmed into a die with a handle.




                                       •A properly trimmed die handle is slightly
                                       larger in diameter than the preparation




Rosensteil (2001) Contemporary Fixed Prosthodontics 3rd edition Mosby
•Improperly trimmed die with a handle that
                 meets the preparation at an angle



         •Handle should be 1 inch long


                       •The die is trimmed with an acrylic bur



•Shaping of the handle near the finish line is completed with a
scalpel

                    •The die is smoothened below the finish
                    line with the discoid end of a tanner carver

•The prepared finish line on the die should be outlined with a red
pencil.

                                    •Die relief agent is painted on the preparation-20 to 40
                                    mm



Rosensteil (2001) Contemporary Fixed Prosthodontics 3rd edition Mosby
DVA Model System:-




                Trimmed impression on                                   Marking dowel pin locations
                   alignment fixture.                                         on clear plate




              Drilling holes for dowel pins                               Inserting dowels in the
                        as marked                                                baseplate
Rosensteil (2001) Contemporary Fixed Prosthodontics 3rd edition Mosby
Impression is poured, stone placed around dowel pins &
                      alignment fixture replaced over poured impression




                                              Set cast is removed from baseplate
Rosensteil (2001) Contemporary Fixed Prosthodontics 3rd edition Mosby
Cast is trimmed                             Cast is sectioned




                              Trimmed working casts using the DVA Model
                              System
Rosensteil (2001) Contemporary Fixed Prosthodontics 3rd edition Mosby
ZEISER MODEL SYSTEM



                 Zeiser Model System                                    Impression is leveled, blocked out with
                                                                           silicone putty,& positioned over
                                                                                       baseplate




            Pin locations are determined &
            the pinholes drilled in the base.



Rosensteil (2001) Contemporary Fixed Prosthodontics 3rd edition Mosby
Pins are inserted into the                             Impression is poured
                 base.




                                                Base is inverted into the
                                                stone
Rosensteil (2001) Contemporary Fixed Prosthodontics 3rd edition Mosby
Cast is separated from the impression when set &
                   then separated from the base.




                                                   Sectioned cast
  Precision saw aids
sectioning                   Rosensteil (2001) Contemporary Fixed Prosthodontics 3rd edition Mosby
BIBLIOGRAPHY
1.   Philips (1992) Science of dental materials
     11th edition W.B Saunders
2.   Rosensteil (2001) Contemporary Fixed
     Prosthodontics 3rd edition Mosby
3.   Shillenberg (1981) Fundamentals of fixed
     prosthodontics 3rd edition Quintessence
4.   Silver plated dies marginal accuracy of
     cast restorations J Prosth Dent 51;1984:
     768-772
5.   Comparision of surface detail reproduction
     of flexible die materials J Prosth Dent
     1998; 80:485-9
6.   An investigation of epoxy resin dies J
     Prosth Dent 1980;44:45-9
ANY Q??

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Model and die material

  • 2. CONTENTS  Introduction  Review of literature  Definition  Requirements of cast  Requirements of die preparation  Ideal requirements of die material  Materials  Methods  Bibliography
  • 3. INTRODUCTION Direct fabrication of patterns for extracoronal restorations in the mouth is inconvenient, difficult, time consuming, and virtually impossible. A cast and die system captures the necessary information so that it can be transferred to the laboratory. Rosensteil (2001) Contemporary Fixed Prosthodontics 3rd edition Mosby
  • 4. REVIEW OF LITERATURE  James Stackhouse (1970) conducted a study concerning the accuracy of stone dies affected by the dimensional changes in rubber impressions  They concluded that 1. More uniform dies were produced from silicon 2. One silicone material was more significant than the others 3. Perforated tray technique caused the dies to be undersized in diameter 4. Bench setting caused the stone dies to be shorter in length and thicker in diameter
  • 5. Gerald T Nomura et al(1980) evaluated the accuracy, fit, detail registration and Knoop hardness of 3 commercially available resin die systems They concluded : 1. Complete crown epoxy resin dies are undersized 2. MOD onlay epoxy resin dies are accurate 3. Detail duplication of epoxy resin dies is comparable to die stone 4. Hardness values of epoxy resin are less than those of stone
  • 6. Myers M., Hembree J.H.(1982) – conducted a study on the relative accuracy of four removable die systems. 4 die systems were studied i.e. the brass dowel pin, the Plastipin, the J-pin, & Logix Model System & they determined the vertical shift & the horizontal shift of the dies. They concluded that Plastipin exhibited least amount of horizontal shift & the brass dowel pin exhibited greatest shift in both directions.
  • 7. DEFINITION  MODEL : “A MODEL IS A REPLICA OF A TEETH AND THE ASSOCIATED SUPPORTING BONY TISSUE OF A JAW,WHICH IS PREPARED FROM AN IMPRESSION.”  DIE : “A POSITIVE REPRODUCTION OF PREPARED TEETH AND CONSISTS OF A SUITABLE HARD SUBSTANCE OF A SUFFICIENT ACCURACY.”
  • 8. REQUIREMENTS OF THE CAST  Accurate surface detail  Free of voids.  Precise articulation.  Soft tissue should be reproduced Rosensteil (2001) Contemporary Fixed Prosthodontics 3rd edition Mosby
  • 9. REQUIREMENTS FOR THE DIE PREPARATION  Reproduce the prepared tooth exactly.  No bubbles or void  The remaining unprepared tooth structure immediately cervical to the finish line should be 0.5 to 1mm visible.  Adequate access to the margin is imperative. Rosensteil (2001) Contemporary Fixed Prosthodontics 3rd edition Mosby
  • 10. IDEAL REQUIREMENTS FOR DIE MATERIAL  Accurate  Dimensionally stable  Setting expansion and contraction, variations in response to change in temperature need to be minimum  It should reproduce the fine details Rosensteil (2001) Contemporary Fixed Prosthodontics 3rd edition Mosby
  • 11. Strong and durable  Withstand the carving and finishing procedures  The color should contrast that of the wax to ease the manipulation  Economical  Easy to use Rosensteil (2001) Contemporary Fixed Prosthodontics 3rd edition Mosby
  • 12. MATERIALS  It includes :  Gypsum  Type1-Impression Plaster  Type2-Model Plaster  Type3-Dental Stone  Type4-Dental Stone(High strength)  Type5 –Dental Stone(High strength and high expansion)  Resin  Epoxy Resin  Polyurathane  Electroplated Dies  Copper plated  Silver plated  Flexible Die Materials  Amalgam used die material  Metal sprayed die Rosensteil (2001) Contemporary Fixed Prosthodontics 3rd edition Mosby
  • 13. GYPSUM  Gypsum(CaSO4.2H2O) is a mineral mined product used extensively in dentistry to make dental models.  In its unrefined state, gypsum is the dihydrate form of calcium sulfate.  Model plaster  Commonly called plaster of Paris, is used primarily for pouring preliminary impressions and the making of diagnostic models.  Dental stone  For use as a working model when a more durable diagnostic cast is required. Philips (1992) Science of dental materials 11th edition W.B Saunders
  • 14.
  • 15. - Die Stone, High Strength (Type IV): •α-hemihydrate of the “Densite” type. •Cuboidal shaped particles & reduced surface area produce such properties without undue thickening of mix. •W/P ratio – 0.22 – 0.24 •Setting time - 12±4min. •2hr Setting Expansion – Maxi. 0.10% •1hr compressive strength – 5000psi. Philips (1992) Science of dental materials 11th edition W.B Saunders
  • 16. Die Stone, High Strength, High Expansion (Type V)  Higher compressive strength than Type IV.  Setting Expansion – 0.10% - 0.30%.  W/P ratio – 0.18 – 0.22  Setting time - 12±4min.  1hr compressive strength – 7000psi. GYPSUM HARDENER Philips (1992) Science of dental materials 11th edition W.B Saunders
  • 17. RESINS EPOXY RESIN  Used effectively with rubber based impression materials  available in the form of a paste to which an activator is added to initiate hardening  Care should be taken that the activator not come in contact with the skin as it is toxic Philips (1992) Science of dental materials 11th edition W.B Saunders
  • 18. PROPERTIES  Working time -15min  Setting time 1 to 12 hours depending on the products  Compressive strength after 7days is 16,000psi  Abrasion resistance is superior to stone dies  Dimensional change due to shrinkage during polymerization is between 0.03% to 0.3% and continues to occur for up to 3 days  Epoxy resin are very viscous when pored hence porosity can occur Philips (1992) Science of dental materials 11th edition W.B Saunders
  • 19. Advantages 1. More resistant to abrasion 2. Dimensionally stable  Disadvantage 1. The epoxy resin cannot be readily introduced into the details of a large impression as dental stone and requires a centrifugal machine for the same 2. It shrinks by about 0.1to 0.2% in about 24 hours 3. It is expensive Philips (1992) Science of dental materials 11th edition W.B Saunders
  • 20. ELECTROPLATED DIES  Electroplated dies are the ones that are produced when an impression material is electroplated  When a die is made in this manner this process is known as electroforming  The impression materials which can be electroplated are impression compound and elastomeric materials  The types of dies are- - Copper plated dies - Silver plated dies  The popularity of copper plated dies began in the early 1930’s Philips (1992) Science of dental materials 11th edition W.B Saunders
  • 21. ADVANTAGES  No dimensional changes occur during electro deposition of a metal  It reproduces the impression accurately  The die is tough and has good strength characteristics Philips (1992) Science of dental materials 11th edition W.B Saunders
  • 22. COPPER PLATED DIES  Impression compound is usually copper plated  The impression material is the cathode and it is connected to the anode which is made of electrolytically pure copper and is immersed in the plating solution so that the area of copper immersed is approximately equal to that of the impression to be plated  COMPOSITION OF SOLUTION FOR COPPERPLATING BATHS Copper Sulphate (crystals) - 200gms H2SO4 (conc) - 30ml Phenol Sulfonic Acid - 2ml Water Distilled - 1000ml Philips (1992) Science of dental materials 11th edition W.B Saunders
  • 23. TECHNIQUE  The surface of the impression is coated with a conductor of electricity such as graphite, copper powder, silver before it is attached to the cathode lead wire. This process is known as “metalizing”. This determines the surface character of the finished die  The copper sulphate is the source of copper, the sulphuric acid increases the conductivity and phenol sulfonic acid helps to assist the penetration of the copper crystals into the deeper parts of the impression  Initially 15 ma current is given which can later be increased to 2 to 3 times the initial current  The plating is allowed to proceed for 12 to 15 hours (usually overnight) Philips (1992) Science of dental materials 11th edition W.B Saunders
  • 24. SILVERPLATED DIES  Silver plating is done over rubber based impression materials  Silver plated dies show more vertical change than stone dies, the difference being between 0.25% to 0.45% depending on the impression material , while the horizontal changes are not significant  COMPOSITION OF THE SOLUTION Silver cyanide - 36gm Potassium cyanide - 60gm Potassium carbonate - 45gm Water (distilled) -1000ml Silver plated dies marginal accuracy of cast restorations J Prosth Dent 51;1984: 768-772
  • 25. Technique  The impression is first made conductive by brushing the surface with powdered silver  A current of 5ma is suitable to start plating a single tooth impression and 10 ma for larger areas  Once a layer of silver is deposited the current can be doubled or trebled  Time period is usually 12 to 15 hours Silver plated dies marginal accuracy of cast restorations J Prosth Dent 51;1984: 768-772
  • 26. FLEXIBLE DIE MATERIALS  They are similar to heavy bodied silicone or polyether impression materials  Selection of a compatible die and impression material is very important in case of flexible dies  Advantages over die stone  Rapid setting  Ease to removal Comparision of surface detail reproduction of flexible die materials J Prosth Dent 1998; 80:485-9
  • 27. AMALGAM DIES  Model amalgam is similar to silver amalgam which is used for fillings  It is used to make hard metal dies which reproduce fine details and sharp margins from impression compound of prepared teeth  They cannot be made in hydrocolloid impressions as they cannot withstand condensation pressure  After packing the impression with amalgam the die can be removed after a minimum of 12 hours, by gently warming the compound Philips (1992) Science of dental materials 11th edition W.B Saunders
  • 28. As amalgam is a good conductor of heat , softened wax applied to them cools rapidly  This may produce internal stresses which may distort the wax pattern after removal from the die  Sudden cooling of the wax may also result in contraction of the wax away from the die  A separating agent is needed as with die stone Philips (1992) Science of dental materials 11th edition W.B Saunders
  • 29. METAL SPRAYED DIES  A bismuth – tin alloy which melts at 138oCcan be sprayed directly on to an impression to form a metal shell which can than be filled with dental stone  A metal coated die can be obtained rapidly from elastomeric impression material  Disadvantage the alloy is soft care is needed to prevent abrasion of the die Philips (1992) Science of dental materials 11th edition W.B Saunders
  • 30. CAST & DIE SYSTEMS 1) Working cast with removable die i. Straight dowel pin ii. Curved dowel pin iii. Di-lok tray iv. Pindex system 2) Working cast with separate die 3) DVA model system 4) Zeiser model system Shillenberg (1981) Fundamentals of fixed prosthodontics 3rd edition Quintessence
  • 31. STRAIGHT DOWEL PIN  The brass dowel pin is one of the most accurate dowel types in terms of resisting horizontal displacement and the second lowest in vertical deviation of four types of removable dies.  A dowel pin is positioned over each prepared tooth in the impression.  Place a dowel between the arms of a bobby. Shillenberg (1981) Fundamentals of fixed prosthodontics 3rd edition Quintessence
  • 32. Push a straight pin between the arms of the bobby pin and into the impression material on both the buccal and the lingual surfaces of each tooth to have a dowel pin placed over it.  Stabilize the dowel in the bobby pin.  Pour die stone into the impression, filling the impressions of the teeth and covering the knurled end of the dowel pin.  The pin should parallel the long axis of the preparation. Shillenberg (1981) Fundamentals of fixed prosthodontics 3rd edition Quintessence
  • 33. When the stone is hard and dry, use a saw frame with a thin blade There should be a cut on the mesial and distal side of each die, and the cuts should taper toward each other slightly from occlusal to gingival.  Take the die form the cast and trim away excess stone gingival to the finish line.  Complete the trimming of the die with a no.25 blade in the laboratory knife and then mark the finish line with the red pencil.  Repeat the procedure for each die on the cast. Shillenberg (1981) Fundamentals of fixed prosthodontics 3rd edition Quintessence
  • 34. CURVED DOWEL PIN  To install pin before pouring the impression, use finger pressure to insert tip of dowel into large opening of position bar.  Hold the bar faciolingually, so that head of the dowel is 1-2mm into the proposed area of impression.  The tail of dowel extends facially; however if the tooth is linguoversion, turn it towards lingual side for easy removal. Shillenberg (1981) Fundamentals of fixed prosthodontics 3rd edition Quintessence
  • 35. Insert a straight pin into one of 3 holes into the facial aspect of bar and into the facial flange of impression and another pin into lingual flange through lingual holes of bar.  The dowel should not touch the impression and its head should be parallel to long axis of prepared tooth or teeth.  This procedure is repeated for all abutments and pontic areas.  One pin is placed near the center of each segment of unprepared teeth, this wall help in removal of segment for better access of gingival wax pattern.  Impression is poured with die stone until it covers heads of dowel. This will fill the impression about 4 mm above gingival finish line.  The straight pins and positioning bar are removed as soon as stone is set. Shillenberg (1981) Fundamentals of fixed prosthodontics 3rd edition Quintessence
  • 36. To assist in orienting each large segments of unprepared teeth, cut a 2mm deep hole on either side of each dowel with a large acrylic bur. Petrolatum is applied on stone and also an exposed part of dowel for easy separation from the base. Shillenberg (1981) Fundamentals of fixed prosthodontics 3rd edition Quintessence
  • 37. •Impression is boxed, allowing the tails of the dowels to extend slightly through the heat softened wax. •Fill the boxed impression with dental stone. The dowel should be covered by at least 2mm of stone. •After the stone has hardened, make vertical saw cuts on either side of each die. •A die is removed by pressing the dowel Shillenberg (1981) Fundamentals of fixed prosthodontics 3rd edition Quintessence
  • 38. TO PLACE THE DOWELS AFTER THE CAST HAS BEEN MADE. •Pour the impression with die stone to form a horseshoe shaped working cast. •Trim the bottom of cast flat to level 10mm from the necks of teeth.This is done because thin cast are easy to saw and short dowels are more stable than larger ones. •Drill a 5mm deep hole in the bottom of the cast directly under the center of each prepared tooth, pontic area, and segment containing unprepared teeth. •This can be made with 2mm diameter drill in hand piece or drill press. Shillenberg (1981) Fundamentals of fixed prosthodontics 3rd edition Quintessence
  • 39. •Clean the dowel holes, insert the curved dowel pin properly and then adjusted for proper fit. •Cement the dowels into holes one at time with placing a drop of cyanoacrylate cement into each hole. •The head of a curved dowel is seated into the holes. •Seat the heads completely with tail pointing facially. •Then same procedure of pouring base and preparing dies is repeated Shillenberg (1981) Fundamentals of fixed prosthodontics 3rd edition Quintessence
  • 40. PINDEX SYSTEM(Coltene/Whaledent,Mahwah,NJ)  In the pindex system a reverse drill press is used to create a master cast with dies that can be removed and replaced repeatedly with great precision.  The impression is poured without positioning and attaching dowel pins beforehand.  The machine accurately drills parallel holes from the underside of trimmed cast. Shillenberg (1981) Fundamentals of fixed prosthodontics 3rd edition Quintessence
  • 41. PINDEX SYSTEM Diagram showing the pindex machine Shillenberg (1981) Fundamentals of fixed prosthodontics 3rd edition Quintessence
  • 42. •Pour the impression, adding approximately 20mm of stone. •Wet the cast prior to trimming •Then trim the bottom of the cast, resting the heels on the table of the trimmer. •It should sit perfectly flat on a tabletop, and its thickness must be a minimum of 15mm. Shillenberg (1981) Fundamentals of fixed prosthodontics 3rd edition Quintessence
  • 43. •Periphery of the cast should be trimmed. •Remove any excess stone in the palate/tongue area with an arbor band on a lathe. •The lingual border of the cast should taper slightly toward the base to facilitate removal of the dies from the cast later. •The faciolingual width -20mm. •Use a pencil mark the desired location of the pins on the occlusal surfaces of the teeth or preparations. Shillenberg (1981) Fundamentals of fixed prosthodontics 3rd edition Quintessence
  • 44. •Place the prepared cast on the worktable and align the first pencil mark with the illuminated dot from the light beam director. •Using both hands, exert firm downwards pressure on the cast with thumbs. •Raise the handle bar with slow, even pressure and the drill assembly moves upwards cutting the pinholes. •When proper depth is achieved, red light goes off. •Same procedure is repeated with each mark. •For better results, cast is made slightly damp to prevent dust formation. Shillenberg (1981) Fundamentals of fixed prosthodontics 3rd edition Quintessence
  • 45. •Compressed air and brush is used to remove debris from holes. The pin holes are refined with hand reamer. •Cyanoacrylate cement is placed on the pins prior to cementing the pin tips. •Shorter pins are placed before the long pins in lingual or palatal holes and long pins in the facial holes. Shillenberg (1981) Fundamentals of fixed prosthodontics 3rd edition Quintessence
  • 46. •White sleeves are placed on the long pins and gray sleeves on the short pins. •The bottom of the cast is lightly coated with the petrolatum. •Gray sleeves are blocked with small amount of molten wax to prevent the sleeve from filling with stone when secondary base is added. •Strip of utility wax along the ends of the long pins to facilitate removal of the dies later. Shillenberg (1981) Fundamentals of fixed prosthodontics 3rd edition Quintessence
  • 47. •A palatal or tongue filler is made of boxing wax. •The filler is seated to the cast. •Boxing wax is applied aaround the cast. •Base is poured with the die stone. Shillenberg (1981) Fundamentals of fixed prosthodontics 3rd edition Quintessence
  • 48. •When stone becomes hard, the cast is seated in the base former. •Saw cuts are premarked with the pencil. •Then dies are sectioned from the underside. •It may also be sectioned from the occlusal aspect. Shillenberg (1981) Fundamentals of fixed prosthodontics 3rd edition Quintessence
  • 49. After the die are sectioned, trim them in a conventional manner.  Mark the finish line with red pencil.  Apply die hardener and die spacer.  Then place the completed cast on the articulator and then cast is ready for fabrication of the wax pattern. Shillenberg (1981) Fundamentals of fixed prosthodontics 3rd edition Quintessence
  • 50. DI-LOK TRAY SYSTEM  A snap apart plastic tray with internal orienting grooves and notches is used to reassemble working cast and dies. Shillenberg (1981) Fundamentals of fixed prosthodontics 3rd edition Quintessence
  • 51. TECHNIQUE  The cast should be poured in a U shape, with no stone in the center building it up to 2.5cm. (1.0 inch)  A lingual side of the cast base is trimmed with an arbor band.  Horizontal grooves are cut in the base to for retention.  When stone has set for 1 hr, separate it from impression.  Cast is trimmed in horseshoe configuration to fit in Di-lok tray and the buccal border is tapered towards base with arbor band. Shillenberg (1981) Fundamentals of fixed prosthodontics 3rd edition Quintessence
  • 52. Soak the base of cast with water for 5 min.  Pour the base in tray, until ¾ of its is filled  Seat the cast on tray; in such a way that cervical line of the prepared teeth should be approximately 4mm above the level of base.  Wipe off the excess stone.  Allow the stone to set until it is hard and dry .  To complete the dies, the cast must be removed from the tray. Shillenberg (1981) Fundamentals of fixed prosthodontics 3rd edition Quintessence
  • 53. •Disassemble the tray by lifting the back up, and then slide the buccal segment forward. •Then with a saw frame and a thin saw blade, cut between the prepared tooth and the adjacent tooth. •The saw cut should start in the interdental papilla area and extend downward on a very slight taper. •The occlusal saw cut should extend three- quarters of the way through the stone base. •Use finger pressure to break the die and attached teeth from the cast. Shillenberg (1981) Fundamentals of fixed prosthodontics 3rd edition Quintessence
  • 54. •Remove excess stone gingival to the finish line with a pear-shaped acrylic bur. •Then cast and dies are reassembled in the tray. •Then the cast and tray mounted on the articulator. •When the stone has set, the articulated cast in the Di-lok tray is ready for the fabrication of the wax pattern. Shillenberg (1981) Fundamentals of fixed prosthodontics 3rd edition Quintessence
  • 55. WORKING CAST WITH SEPARATE DIE(MULTI-POUR TECHNIQUE)  ADVANTAGES  Simple  Slightly more accurate.  Minimum trimming.  DISADVANTAGES  Difficult to transfer complex or fragile wax patterns from cast to die.  Seating the pattern on the cast may be problematic.  Technique can be used with elastomeric impression materials. Rosensteil (2001) Contemporary Fixed Prosthodontics 3rd edition Mosby
  • 56.  The area of preparation is poured with the stones in small increments.  When set,it is separated.A second pour is then made of the entire arch. •The first pour which is more accurate is trimmed into a die with a handle. •A properly trimmed die handle is slightly larger in diameter than the preparation Rosensteil (2001) Contemporary Fixed Prosthodontics 3rd edition Mosby
  • 57. •Improperly trimmed die with a handle that meets the preparation at an angle •Handle should be 1 inch long •The die is trimmed with an acrylic bur •Shaping of the handle near the finish line is completed with a scalpel •The die is smoothened below the finish line with the discoid end of a tanner carver •The prepared finish line on the die should be outlined with a red pencil. •Die relief agent is painted on the preparation-20 to 40 mm Rosensteil (2001) Contemporary Fixed Prosthodontics 3rd edition Mosby
  • 58. DVA Model System:- Trimmed impression on Marking dowel pin locations alignment fixture. on clear plate Drilling holes for dowel pins Inserting dowels in the as marked baseplate Rosensteil (2001) Contemporary Fixed Prosthodontics 3rd edition Mosby
  • 59. Impression is poured, stone placed around dowel pins & alignment fixture replaced over poured impression Set cast is removed from baseplate Rosensteil (2001) Contemporary Fixed Prosthodontics 3rd edition Mosby
  • 60. Cast is trimmed Cast is sectioned Trimmed working casts using the DVA Model System Rosensteil (2001) Contemporary Fixed Prosthodontics 3rd edition Mosby
  • 61. ZEISER MODEL SYSTEM Zeiser Model System Impression is leveled, blocked out with silicone putty,& positioned over baseplate Pin locations are determined & the pinholes drilled in the base. Rosensteil (2001) Contemporary Fixed Prosthodontics 3rd edition Mosby
  • 62. Pins are inserted into the Impression is poured base. Base is inverted into the stone Rosensteil (2001) Contemporary Fixed Prosthodontics 3rd edition Mosby
  • 63. Cast is separated from the impression when set & then separated from the base. Sectioned cast Precision saw aids sectioning Rosensteil (2001) Contemporary Fixed Prosthodontics 3rd edition Mosby
  • 64. BIBLIOGRAPHY 1. Philips (1992) Science of dental materials 11th edition W.B Saunders 2. Rosensteil (2001) Contemporary Fixed Prosthodontics 3rd edition Mosby 3. Shillenberg (1981) Fundamentals of fixed prosthodontics 3rd edition Quintessence 4. Silver plated dies marginal accuracy of cast restorations J Prosth Dent 51;1984: 768-772 5. Comparision of surface detail reproduction of flexible die materials J Prosth Dent 1998; 80:485-9 6. An investigation of epoxy resin dies J Prosth Dent 1980;44:45-9