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Composite preparation

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Composite preparation

  1. 1. Clinical technique of composite restoration presented by: Faisal Alanazi
  2. 2. <ul><li>Clinical technique of composite restoration </li></ul><ul><li>Initial clinical procedures, </li></ul><ul><li>Tooth preparation for composite </li></ul><ul><li>Restorative technique for composite </li></ul><ul><li>Repairing composite restorations </li></ul><ul><li>Fahad will complete C and D </li></ul>
  3. 3. Clinical technique <ul><li>Initial clinical procedures, </li></ul><ul><li>1. Local anesthesia - patient is more relaxed </li></ul><ul><li>- reduced salivation </li></ul><ul><li>2. Preparation of operating site – </li></ul><ul><li>clean the operating site with slurry of pumice to remove any debris, plaque , pellicle, and superficial stains . Calculus removal </li></ul><ul><ul><li>Prophy pastes containing flavoring agents, or fluorides act as contaminants and should be avoided to prevent a possible conflict with the acid-etch technique. </li></ul></ul>
  4. 4. 3.Shade selection <ul><li>Color varies with translucency, thickness of enamel and dentin, age of the patient, presence of any external or internal stains </li></ul><ul><li>Different color zones are present - incisal third is lighter and translucent than cervical third. Middle third is blend of two </li></ul>
  5. 8. <ul><li>Vita Lumin: </li></ul><ul><li>A= reddish brown </li></ul><ul><li>B = reddish yellow </li></ul><ul><li>C = grey shades </li></ul><ul><li>D = reddish grey </li></ul>B1 A1 B2 D2 A2 C1 C2 D4 A3 D3 B3 A3.5 B4 C3 A4 C4
  6. 9. 3D Master
  7. 10. <ul><li>1. Determine shade at the start of an appointment (before the tooth is subjected to dehydration) </li></ul><ul><li>2. Use either natural light (not direct sunlight) or a colour corrected artificial light source. </li></ul><ul><li>3. Drape the patient with a neutral colored cover if clothing is bright </li></ul><ul><li>4. Assess value by squinting . The reduced amount of light entering the eye allows the retinal rods to better distinguish degrees of lightness and darkness. (Vita Lumin shade tabs set in order of value ) </li></ul><ul><li>5. Make rapid comparisons with shade tabs (no more than 5 seconds each viewing) Make the selection rapidly to avoid eye fatigue </li></ul>
  8. 11. <ul><li>If more time (more than 30) required then look at complimentary colors (blue/violet) this revitalizes and resensititze the color receptors in the eye </li></ul>
  9. 12. <ul><li>6. Choose the dominant hue and chroma within the value range chosen. The canines - useful guide to assessing hue. </li></ul><ul><li>7. Compare selected tabs under different conditions eg wet vs dry, different lip positions, artificial and natural light from different angles. </li></ul><ul><li>8. Look carefully for colour characterisation such as stained imbrication lines, white spots, neck colouration, incisal edge translucency </li></ul>
  10. 13. Automated Shade Selection
  11. 14. <ul><li>B.Tooth preparation for composite </li></ul><ul><li>4.Cavity preparation </li></ul>
  12. 15. Tooth preparation principles and criteria <ul><li>External Outline form </li></ul><ul><li>Extent is determined by size, shape, and location of defect . </li></ul><ul><li>should include all Caries, any fault, defective, old friable tooth structure. </li></ul><ul><li>Removal of discolored tooth structure as required for esthetics. </li></ul><ul><li>Create prepared enamel margin of 90° or greater by giving bevel wherever required. </li></ul><ul><li>Create 90° cavosurface on root surfaces </li></ul><ul><li>Pulpally, no uniform depth is needed </li></ul><ul><li>Depth should be sufficient to identify and remove caries or existing restoration. </li></ul>
  13. 16. <ul><li>RETENTION </li></ul><ul><li>Micromechanical retention by etching of enamel and dentin. </li></ul><ul><li>Mechanical undercuts when margins terminate in cementum. </li></ul>
  14. 17. <ul><li>Advantages of beveling. </li></ul><ul><li>Increase in surface area because stronger enamel to resin bond </li></ul><ul><li>Ends of enamel rods are etched. </li></ul><ul><li>Esthetic blending due to cavosurface bevel. </li></ul>
  15. 19. <ul><li>Cavity designs for composite cavity preparation </li></ul><ul><li>Conventional </li></ul><ul><li>Beveled conventional </li></ul><ul><li>Modified </li></ul><ul><li>Box shape </li></ul><ul><li>Facial/lingual slot </li></ul>
  16. 20. <ul><li>CONVENTIONAL </li></ul><ul><li>similar to that of cavity preparation for amalgam restoration. </li></ul><ul><li>A uniform depth of the cavity with 90° cavosurface margin is required </li></ul><ul><li>INDICATIONS </li></ul><ul><li>Moderate to large class I and class II restorations </li></ul><ul><li>Preparation is located on root surfaces. </li></ul><ul><li>Old amalgam restoration being replaced </li></ul>
  17. 21. <ul><li>BEVELED CONVENTIONAL </li></ul><ul><li>Similar to conventional cavity design </li></ul><ul><li>Have some beveled enamel margins. </li></ul><ul><li>INDICATIONS </li></ul><ul><li>Composite is used to replace existing restoration. </li></ul><ul><li>(class III, IV, V) </li></ul><ul><li>Restore large area </li></ul><ul><li>Rarely used for posterior composite restorations </li></ul>
  18. 23. Combined design
  19. 24. <ul><li>MODIFIED </li></ul><ul><li>No specified wall configuration. </li></ul><ul><li>No Specified pulpal or axial depth. </li></ul><ul><li>All parameters determined by extent of caries. </li></ul><ul><li>Conserve tooth and obtain retention (MICRO MECHANICAL). </li></ul><ul><li>Scooped out appearance </li></ul><ul><li>INDICATIONS </li></ul><ul><li>small, cavitated, carious lesion surrounded by enamel </li></ul><ul><li>correcting enamel defects. </li></ul>
  20. 26. <ul><li>BOX ONLY </li></ul><ul><li>When only Proximal surface is faulty and no lesion on occlusal surface </li></ul>
  21. 27. <ul><li>FACIAL OR LINGUAL SLOT </li></ul><ul><li>Lesion is proximal but access is possible through facial or lingual surface </li></ul><ul><li>Cavosurface is 90 or greater. </li></ul><ul><li>Direct access for removal of caries. </li></ul>
  22. 33. <ul><li>5. Isolation of operating site </li></ul><ul><li>- Rubber dam </li></ul><ul><li>- cotton rolls </li></ul><ul><li>- retraction cord </li></ul><ul><li>6 . Pulp protection </li></ul><ul><li>Calcium hydroxide, GIC , RMGI </li></ul><ul><li>ZnOE is contraindicated </li></ul>
  23. 34. 7. Matrix placement <ul><li>Two types of matrices are available </li></ul><ul><li>- Polyester matrix </li></ul><ul><li>- metal matrix </li></ul><ul><li>Various matrix retainer which can be used are </li></ul><ul><li>Tofflemire retainer </li></ul><ul><li>Compound supported metal matrix </li></ul><ul><li>Sectional matrix system- palodent contact matrix </li></ul>
  24. 37. <ul><li>Polyester matrix </li></ul><ul><li>- used especially CLASS III, CLASSIV ,CLASS V cavities </li></ul><ul><li>Advantage - they allow the light to pass </li></ul><ul><li>Disadvantage - they are not rigid and get deform during placement of rigid material and contact cannot be properly restored </li></ul><ul><li>Metal matrix </li></ul><ul><li>- Ultrathin metal matrices 001- .002 inch are used </li></ul><ul><li>- Band should be precontoured outside the mouth </li></ul>
  25. 38. Thank you Theodore.M.Roberson,Harald.O.Heymann,Edward.J.SwiftJR.Sturdevant's Art and Science of Operative Dentistry.Mosby publications;2002; 483-492 Reference

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