Materials & Restorations Dr S.E.Jabbarifar April 2009.

Slides:



Advertisements
Similar presentations
Chapter 44 Dental Liners, Bases and Bonding Systems
Advertisements

Objectives: Cavity preparation is relationship with pulp
Pulp Protection:Liners,Varnishes & Bases DR Ramesh Bharti Assistant Professor Conservative Dentistry & Endodontics FODS, KGMU,Lucknow.
33 Chairside Restorative Materials. 2 Introduction Materials are generally divided and categorized according to their functions. The American Dental Association.
Dental Liners, Bases, and Bonding Systems
Classification of filling materials There are several classification of filling materials. Depending to which group the tooth belongs, filling materials.
Introduction to: cavity varnish, liners and bases
Fundamentals in Tooth Preparation
DHYG 113 Restorative Dentistry I
Dental Materials Restorations, Luting and Pulp Therapy Introduction.
Newer concepts in classification of carious lesions
FIXED PROSTHODONTICS ( CROWN & BRIDGE )
Conservative treatment of caries, when the pulp is vital and unexposed, is by filling.
Fissure sealants DCP1 S2 Lecture 8 - part 1 By Dr A. Eldarrat & A. Uni
Provisional Restorations
Provisional Restorations
CLINICAL PEDIATRIC DENTISTRY I DSV 441 CHAPTER 21 MANAGEMENT OF TRAUMA TO THE TEETH AND SUPPORTING TISSUES II EMERGENCY TREATMENT AND TEMPORARY (pages.
Porcelain Inlay and Onlay
Dental Liners, Bases, and Bonding Systems
DENTAL CEMENTS DR.LINDA MAHER.
Copyright © 2006 Thomson Delmar Learning. ALL RIGHTS RESERVED. 1 PowerPoint ® Presentation for Dental Materials with Labs Module: Prosthodontics: Fixed.
Class II Restorations Dr Jamal Naim Dean of the faculty of dentistry
Surface properties and adhesion
DH220 Dental Materials Lecture #2 Prof. Lamanna RDH, MS.
Caries managements Is Restoration required??. Traditional caries management has consisted of detection of caries lesion followed by immediate restoration.
PEDIATRIC OPERATIVE DENTISTRY (cont.)
Clinical Application of restorative materials. Successful results in operative dentistry cannot be achieved without using proper restorative materials.
Prosthetic III. Fixed dentures. Restore the form (and function) Cemented on (in the ) prepared teeth Can not be removed.
Introduction to Operative Dentistry
RETAINERS DEFINITION:
General Dentistry/ Matrix Systems
Ternopil State Medical University named by I. Horbachevskyj Department of Therapeutic Dentistry Topic: Filling materials for permanent and temporary fillings.
Mistakes done during cavity preparation and during cavity filling.
Bonding of resin-based materials Libyan International Medical University.
Module 5 Restorative Dentistry. The Aims of Restorative Dentistry To restore teeth and gums To prevent the advance of caries and periodontal diseases.
Crowns Bridges Inlays/Onlays Veneers Fixed Prosthodontics.
Quiz April.
Features preparation carious cavities different classes in temporary and permanent teeth in children. Cavity Preparations.
©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in.
SESSION XIII - RESTORATION dr B.Cerkaski preclinical course
Dr. Gaurav Garg (M.D.S.) Lecturer, College of Dentistry Al Zulfi, MU.
Dental Restorations Dr Huda Yaser.
Instructions for Clinic
Dept. of Restorative Dentistry Dental College, Zulfi Almajmaa University Saudi Arabia.
Restorative treatment of discolored anterior teeth III
Purposes of Operative Dentistry
Dental material DENTAL CEMENTS z
Restorative Dentistry
Dental Cement Dr. Hicham Nuaimi BDS. PGDip Implantology
Class V. cavity preparation and restoration
Glass ionomer restorative cement systems: An update
محاضرات المرحله الرابعه
CROWN AND BRIDGE.
Lecture 4: Radiographic Interpretation of Dental Caries
Stainless steel crown.
Operative Dentistry.
Class IV Cavity Preparation
Gate toward Operative Dentistry
All About Porcelain Veneers
معالجة / د . عبد العظيم (م 1)
Dr. Emad Farhan Alkhalidi
Lecturer: Servatovych Anhelina Therapeutic Dentistry Department SHEI “ I.Ya. HORBACHEVSKY TERNOPIL STATE MEDICAL UNIVERSITY HEALTHCARE MINISTRY OF UKRAINE”
Introduction to Dental Materials
DESIGN OF COMPLEX AMALGAM PREPARATION
New Cavity Classification:
Presentation transcript:

Materials & Restorations Dr S.E.Jabbarifar April 2009

Materials & Restorations Back to basics !

Topics we will cover today Choice of materials Their properties and uses Their properties and uses Their advantages & disadvantages Their advantages & disadvantages Why do restorations fail ? Preserving tooth structure Repairing old fillings Temporary or Provisional restorations

Choosing Materials Lets look at the pros & cons & uses of these direct restoratives: Amalgam Amalgam Composite resins Composite resins Glass ionomer Glass ionomer Resin modified glass ionomer Resin modified glass ionomer Poly acid modified resins (compomers) Poly acid modified resins (compomers) Calcium Hydroxide Calcium Hydroxide Zinc Oxide & Eugenol Zinc Oxide & Eugenol

Choosing Materials Lets also look at the pros & cons & uses of these indirect restoratives: Acrylic Acrylic Chrome Cobalt Chrome Cobalt Porcelain Porcelain Gold Gold

Why do Restorations Fail ? Poor Design Wrong material used Wrong material used Inadequate thickness Inadequate thickness Margins in occlusion Margins in occlusion Built-in errors cause caries, eg. Overhang Built-in errors cause caries, eg. Overhang Inadequate retention Inadequate retention Porosity, poor packing or finishing Porosity, poor packing or finishing Pulpal damage, poor lining Pulpal damage, poor lining

Why do Restorations Fail Subsequent Changes Recurrent caries Recurrent caries Tooth fracture Tooth fracture Attrition, abrasion, erosion Attrition, abrasion, erosion Pulpal necrosis Pulpal necrosis Tooth movement or loss causes increase or changes to applied forces Tooth movement or loss causes increase or changes to applied forces Trauma Trauma Exceed working life or just wear out Exceed working life or just wear out

Preserving Tooth Structure Saving enamel Minimal invasion dentistry ART technique Tunnel preps Adhesive dentistry Repairing old restorations

Preserving Tooth Structure What are we trying to preserve? Remember basic dental anatomy Outer Enamel Hard, inflexible Hard, inflexible Prism structure Prism structure Inner Dentine Softer, more flexible Softer, more flexible Vital structure Vital structure

Preserving Tooth Structure Natural tooth structure is irreplaceable….. THINK HARD before you cut ! Your replacement will never be as good Your replacement will never be as good The tooth will become weaker The tooth will become weaker You are reducing the patients options You are reducing the patients options There is more to go wrong in future There is more to go wrong in future You will probably be shortening the life of this tooth, and possibly the WHOLE dentition You will probably be shortening the life of this tooth, and possibly the WHOLE dentition Practice true CONSERVATIVE DENTISTRY

Preserving Tooth Structure Ideally, our restoration should mimic the natural tooth structure GIC replaces Dentine Softer, more flexible Softer, more flexible Hydrophilic Hydrophilic Composite replaces Enamel Hard, inflexible Hard, inflexible hydrophobic hydrophobic

Saving Enamel Where do the enamel prisms run ? Can we leave unsupported enamel If so under what circumstances ? Where can we preserve enamel ? Incisally Prevent class 3 turning to class 4 if possible Marginal ridge tunnel prep or sideways prep Interproximally Palatal approach to Class 3 Just enough for matrix on Class 2 Gingivally Conserve margin, keep supragingival

Minimal Invasion Dentistry Removal of enamel caries Removal of soft, heavily infected dentine Restore with cariostatic, adhesive material Consider stepwise excavation & stabilization AVOID Removing sound tooth structure Removing sound tooth structure Exposure of pulp Exposure of pulp Remember the ART technique ?

Tunnel Prep Used for small Class 2 lesions Contact point and marginal ridge are preserved Tooth strength is retained T shaped access cavity

Tunnel Prep T shaped access Remove caries ? matrix Pack GIC Composite What about the interproximal enamel ? enamel ? pulp 4546

Sideways Prep Used for small Class 2 lesions Contact point and marginal ridge are preserved Buccal access cavity

Adhesive Dentistry Eliminates the need to cut a retentive cavity Can support unsupported enamel Reduces need for extensive crown or bridge prep. Eg -Maryland bridge Eg -Maryland bridge Can eliminate preparation completely Eg –diastema closure, composite bridge Eg –diastema closure, composite bridge Prolongs the life of restorations, thus reduces the number of re-cuts REMEMBER- fillings never get smaller when they are replaced !

Repairing Old Fillings fillings never get any smaller each time you replace them….. So think before you drill and refill Can the old filling be repaired ? Is there hidden caries Is there hidden caries Is the whole structure compromised Is the whole structure compromised Are the aesthetics poor Are the aesthetics poor If NO, consider repair rather than replacement

Methods of Repairing Old Fillings Smoothing & polishing margins Local patching Veneering Bonding, eg replacing lost cusp Mechanical retention, Mechanical retention, Fresh surface cutting, retentive slots, etching, sandblasting, pins Chemical bond Chemical bond Suitable adhesives

Temporary or Provisional Temporary filling- short term only Prevents ingress of food and saliva Prevents ingress of food and saliva Protects vital tooth structures Protects vital tooth structures Prevents tooth movement Prevents tooth movement Allows healing of painful tooth Allows healing of painful tooth May need to be aesthetic (but not too good) May need to be aesthetic (but not too good) Patient must understand the need to return, and what will go wrong if they dont

Temporary or Provisional Provisional filling- medium term Awaiting healing, perio, pulp, endo Awaiting healing, perio, pulp, endo Checking occlusal load / wear patterns Checking occlusal load / wear patterns Testing appearance Testing appearance Testing phonetics Testing phonetics Testing function Testing function Trying raised occlusal position Trying raised occlusal position Patient must understand the need to for regular review and reassessment, and what will go wrong if their treatment is not completed.

Temporary / Provisional Materials Temporary Filling ZnO Eugenol, ZnO Eugenol, Cavit Cavit Temp Bond in acrylic or polycarbonate crown Temp Bond in acrylic or polycarbonate crown Provisional filling GIC GIC Acrylic Acrylic Composite Composite Choose your words, temporary or provisional This will affect your patients expectations This will affect your patients expectations

Materials & Restorations That's all folks Thanks for listening Youve been a great audience