composite restoration

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Composite restoration Atam,USM2012 :

Composite restoration Atam,USM2012

Indication:

Indication Restoration of anterior and posterior teeth Pits and fissure sealants Bonding of ceramic veneers Cementation of fixed prosthesis

Contraindication:

Contraindication High caries incidence and poor oral hygiene High stress bearing area If access and isolation is difficult Patient allergic or sensitive to resin composite

Advantages:

Advantages Esthetics Conservation of tooth structure Adhesion to tooth structure Low thermal conductivity and no galvanic reaction Can be polished at the same appointment

Disadvantages:

D isadvantages Technique sensitive Require rubber dam Expensive Polymerization shrinkage - marginal leakage - secondary caries -postoperative sensitivity Decrease wear resistance

Clinical procedure:

Clinical procedure

1.Isolation and preparation of operating site :

1.Isolation and preparation of operating site 1.Isolation -rubber dam -cotton rolls -retraction cord 2.Preparation of operating site -clean the surface area with slurry of pumice

2.Shade selection:

2.Shade selection Determine the shade at the start of appointment Should be as close to that of the natural tooth as possible

3.Tooth preparation:

3.Tooth preparation Access is gained to carious dentin All caries is removed from the enamel dentin junction and soft caries excavated over the pulp

4.Pulp protection:

4.Pulp protection In deep cavities pulp protection may be necessary prior to acid etch and bonding -Calcium hydroxide, GIC, RMGI - ZnOE is contraindicated

5.Etching procedure :

5.Etching procedure Phosphoric acid ( ideally 37%) For enamel (prism core and periphery) and dentin ( intertubular and peritubular ) in 15 sec and then rinsed off The surface should have a chalky, frosthy white appearance Removes smear layer, microscopic surface rouhgness

PowerPoint Presentation:

EnETCHING ENAMEL- affects both prism core and prism periphery. transforms smooth enamel into very irregular surface. When fluid resin is applied to etched surface Resin penetrates etched surface Forms resin tags Basis for adhesion of resin to enamel

PowerPoint Presentation:

ETCHING DENTIN- Affects intertubular and peritubular dentin. Removes the smear layer and exposes collagen network to achieve optimal adhesion to the dentinal surface. After rinsing, dry the surface but must be kept slightly moistened when dentin is also involved because it allows the primer and adhesive material to more effectively penetrate the collagen fibre to form a hybrid layer which is the basis for mechanical bond to dentin. (2 bottle system,5 th generation)

6.Bonding agent :

6.Bonding agent Application of bonding agent and light cure for 10 sec Required as an adhesive between composite and tooth structure

7.Matrix and Composite placement:

7.Matrix and Composite placement a.Matrix placement -Help to restore the contact area and approximal contour of the crown b.Composite placement -same way as amalgam placement -Incremental placement and curing

PowerPoint Presentation:

Finish & polish Tungsten carbide finishing bur is used to contour the marginal ridge (note the water spray). Rugby ball’-shaped fine diamond is used to contour the occlusal anatomy. All high-speed instruments must be used with water spray. A flexible, abrasive, impregnated disc is used to polish and smooth the occlusal contours.

9.Occlusion and contact point:

9.Occlusion and contact point Occlusion should be checked with articulating paper and adjusted as necessary Contact point is checked with floss and if necessary the interdental area should be polished with a fine abrasive strip

Before the restoration procedure:

After restoring with Composite Resin Material Before the restoration procedure

Polymerization shrinkage:

Polymerization shrinkage Upon composite resin curing, polymerization shrinkage stress will be generated which leads to poor marginal seal thus opening path for migration of microorganisms and potentially inducing secondary caries. Configuration factor(C-factor) - ratio between bonded and un-bonded surfaces where the higher the ratio, the higher is the polymerization stress

Technique to minimize effects of polymerization shrinkage:

Technique to minimize effects of polymerization shrinkage Altered light cure cycles (intensity and time variation) Three sited light curing technique Incremental curing of composites Intermediate elastic bonding concept Stress breaking liners under composites

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