Operative Dentistry 3

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Slide 1 : CHEN Zhi Wuhan University School of Stomatology Operative Dentistry 3
Slide 2 : Indication of Operative Dentistry Caries; Malformed, discolored, or fractured teeth; Restoration replacement.
Slide 3 : Tooth-colored restoration For Class ?,? and ?, Esthetic Dentistry For Class ?and ?,
Slide 4 : What are Tooth-colored materials? What is their working mechanism? What are the cavity preparation futures for tooth-colored restoration?
Slide 5 : What are steps for tooth-colored restoration? What are the advantage & disadvantage of tooth-colored restoration?
Slide 6 : Tooth-Colored Materials Composite resin Glass ionomer cement Compomer
Slide 7 : Composite Resin Traditional composites Hybird composites Flowable composites Condensable composites Packable Universal composites
Slide 8 : Glass Ionomer Chemical adhesion to dentin Release Fluoride
Slide 9 : Compomer Compomer = Composite + Ionomer
Slide 10 : Dental Adhesion or Dental Bonding Adhesion is a process of solid and/or liquid interaction of one material with another at a single interface.
Slide 11 : Enamel bonding system Enamel bongding depends on resin tags becoming interlocked with the surface irregularities created by etching.
Slide 12 : Macrotags: form between enamel rod peripheries. Microtags: smaller tags form across the end of each rod. Macrotags and microtags are the basis for micro-mechanical bonding.
Slide 13 : Dentin bonding system The difficulties of dentin bonding: More water---wet bonding Lower calcification Richer organic---collagen network Smear layer
Slide 14 : The bond strength is primarily related to micro-mechanical bonding to the intertubular dentin which occures between tubules along the cut dentin surface.
Slide 15 : Dentin Bonding Agent, DBA Early DBA were hydrophobic, bonded directly to the dentin smear layer. Bond strengths 6MPa. Later DBA removed the smear layer but tended to over-etch dentin. Bond strengths˜10~12MPa.
Slide 16 : DBA were chemically modified to be more hydrophilic. Bond Strengths˜18~20MPa. Careful dentin conditioning, Coupled with hydrophilic primer, Bond Strength˜22~35MPa.
Slide 17 : The Development of DBA Enamel etch (1955) Dentine etch (1960) Treatment of smear layer (1980) Wet Bonding technique(1990)
Slide 18 : First generation Second generation Third generation Fourth generation: Total etch technique Fifth generation: One bottle system Sixth generation: All in one,2000 Seventh generation
Slide 19 : Cavity Preparation Three designs of cavity preparation: 1.Conventional 2.Beveled conventional 3.Modified
Slide 20 : Beveled conventional cavity preparations are similar to conventional preparation, in that the outline form has external, “box-like” walls, but with beveled enamel margin.
Slide 21 : Beveled enamel margin
Slide 22 : Beveled conventional cavity designs for Class ?, ? and ? preparations
Slide 23 : The advantages : The ends of enamel rods are more etched The increase in etched surface results in a stronger bond Increase the retention and reduce marginal leakage and discoloration. More esthtically
Slide 24 : Modified cavity preparation Have neither specified cavity wall structure nor specified pulpal depth, and have enamel margins. Conserve more tooth structure.
Slide 25 : Modified cavity preparation
Slide 26 : Initial Clinical Procedure Local anesthesia Preparation of the operating site Shade selection Isolation of the operating site with rubber dam or cotton rolls
Slide 27 :
Slide 28 : Rubber dam
Slide 29 : Clinical Procedure Cavity preparation Acid etching enamel & conditioning dentin Matrix application Application of bonding agent Insertion of composite Finishing procedures
Slide 30 :
Slide 31 : Matrix application
Slide 32 :
Slide 33 :
Slide 34 :
Slide 35 :
Slide 36 :
Slide 37 :
Slide 38 : Final procedures
Slide 39 :
Slide 40 : Cases
Slide 41 :
Slide 42 :
Slide 43 : Conservative Operative Dentistry Minimal intervention dentistry is regards as a main stream in caries treatment in the 21st century.
Slide 44 : Principles of Minimal Intervention dentistry Remineralization of early lesions Reduction in cariogenic bacteria, to elminate the risk of further demi-neralization and cavitation Minimum surgical intervention of ca-vitated lesions Repair rather than replacement of defective restorations
Slide 45 : “The day is surely coming, and perhaps within the lifetime of you young men before me, when we will be engaged in practicing preventive, rather than reparative, dentistry. ” GV Black in 1896
Slide 46 : University Minnisota School of Dentistry
Slide 47 : http://202.114.104.243/jpkc/ysysbx/index.html
Slide 48 : Thanks

 


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