Operative Dentistry 3

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1 : CHEN Zhi Wuhan University School of Stomatology Operative Dentistry 3
2 : Indication of Operative Dentistry Caries; Malformed, discolored, or fractured teeth; Restoration replacement.
3 : Tooth-colored restoration For Class ?,? and ?, Esthetic Dentistry For Class ?and ?,
4 : What are Tooth-colored materials? What is their working mechanism? What are the cavity preparation futures for tooth-colored restoration?
5 : What are steps for tooth-colored restoration? What are the advantage & disadvantage of tooth-colored restoration?
6 : Tooth-Colored Materials Composite resin Glass ionomer cement Compomer
7 : Composite Resin Traditional composites Hybird composites Flowable composites Condensable composites Packable Universal composites
8 : Glass Ionomer Chemical adhesion to dentin Release Fluoride
9 : Compomer Compomer = Composite + Ionomer
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.
11 : Enamel bonding system Enamel bongding depends on resin tags becoming interlocked with the surface irregularities created by etching.
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.
13 : Dentin bonding system The difficulties of dentin bonding: More water---wet bonding Lower calcification Richer organic---collagen network Smear layer
14 : The bond strength is primarily related to micro-mechanical bonding to the intertubular dentin which occures between tubules along the cut dentin surface.
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.
16 : DBA were chemically modified to be more hydrophilic. Bond Strengths˜18~20MPa. Careful dentin conditioning, Coupled with hydrophilic primer, Bond Strength˜22~35MPa.
17 : The Development of DBA Enamel etch (1955) Dentine etch (1960) Treatment of smear layer (1980) Wet Bonding technique(1990)
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
19 : Cavity Preparation Three designs of cavity preparation: 1.Conventional 2.Beveled conventional 3.Modified
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.
21 : Beveled enamel margin
22 : Beveled conventional cavity designs for Class ?, ? and ? preparations
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
24 : Modified cavity preparation Have neither specified cavity wall structure nor specified pulpal depth, and have enamel margins. Conserve more tooth structure.
25 : Modified cavity preparation
26 : Initial Clinical Procedure Local anesthesia Preparation of the operating site Shade selection Isolation of the operating site with rubber dam or cotton rolls
27 :
28 : Rubber dam
29 : Clinical Procedure Cavity preparation Acid etching enamel & conditioning dentin Matrix application Application of bonding agent Insertion of composite Finishing procedures
30 :
31 : Matrix application
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38 : Final procedures
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40 : Cases
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43 : Conservative Operative Dentistry Minimal intervention dentistry is regards as a main stream in caries treatment in the 21st century.
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
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
46 : University Minnisota School of Dentistry
47 :
48 : Thanks


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Operative Dentistry 3. Indication of Operative Dentistry. Caries;; Malformed, discolored,practicing    more
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