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Posterior composites

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Posterior composites

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Posterior composites

  1. 1. Posterior Composites
  2. 2. ALLAH’S Thought at all times
  3. 3. Fazal ur Rehman Qazi BDS, FCPS. Asst. Professor Operative Dentistry DIKIOHS,DOW University Karachi
  4. 4. What is Nanotechnology
  5. 5. An emergent science formed from the convergence of chemistry (classically restricted to atomic interaction) and molecular scale physics and biology (previously restricted to the micron scale) Dental update Jan-Feb 2003
  6. 6. Nanofilled Composites • Handling • Easy finishing and polishing • Durability
  7. 7. Preparation for Posterior Composite Restorations
  8. 8. Centric occlusal stops located primarily on tooth structure
  9. 9. Excessive tooth wear from clenching or grinding
  10. 10. Esthetics as a prime consideration
  11. 11. Cavosurface margins in enamel
  12. 12. Follow Directions For Use
  13. 13. Contamination • Biofilm • Gingival Exudate • Saliva • Blood • Eugenol • Handpiece Oil
  14. 14. No special Preparation for Class 1 Composite Restorations
  15. 15. Margins of the Occlusal Preparation should not be Bevelled
  16. 16. Class 2 Composite Restorations
  17. 17. Prewedging
  18. 18. Beveling for facial and lingual margins of the proximal box
  19. 19. Gingival Margins
  20. 20. Occlusal Margins Placement of occlusal bevels has demonstrated no benefit to the longevity of class 2 resin composite restorations
  21. 21. Cavity Liners with Composite Restorations
  22. 22. Calcium- Hydroxide Liner
  23. 23. Glass-ionomer Liners • Improve marginal integrity and decrease marginal leakage (J Dent 1993;21:158-162) Reduce polymerization shrinkage and cuspal deformation(Quintessence Int 1988;19:191-1980 • How should composite be layered to reduce shrinkage stress: Incremental or bulk filling? . (Dental Materials 2008 ; 24 :1501 – 1505)
  24. 24. Glass ionomer liners • SEM and microleakage evaluation of the marginal integrity of two types of class V restorations with or without the use of a light-curable coating • J Dent. 2008 Nov;36(11):885-91. Epub 2008 Aug 30 material and of polishing.
  25. 25. Dental Composites are much stronger than the liners and bases and are equally insulating JADA 1994;125:687-701 Investigation of the electrical properties of some dental composite restorative materials before and after laser exposure Dental materials 2005 ;vol 22 : 885 - 895
  26. 26. Use of glass ionomer liner on dentine cavity surfaces has shown to significantly reduce postoperative sensitivity Am J Dent 2001;14:34-38
  27. 27. Bonded Base Technique
  28. 28. Techniques to make tight contacts • Use of thin sectional matrices • Prewedging • Prepolymerized composite balls • Special wedge shaped composite curing tips.
  29. 29. Do you need to use flowable composite under posterior composite restorations?
  30. 30. The Snow Plow Technique
  31. 31. Improvements in Dentine Bonding Systems
  32. 32. The wet bonding technique has been repeatedly shown to enhance bond strengths Quintessence Int 2001;32:385-390
  33. 33. Nanotechnology Dental Adhesives
  34. 34. Incorporation of organic solvents like acetone or ethanol
  35. 35. Dentine is air dried collagen fibres collapse
  36. 36. Depending on cavity size, dispense 1 or 2 drops of XENO V into a DENTSPLY CliXdish™. Picture DFU
  37. 37. In a closed CliXdish XENO V remains useable for up to 30 minutes. Disassemble for cleaning and disinfection. Picture DFU
  38. 38. Apply XENO V twice, wetting all cavity surfaces uniformly with each application. Picture DFU
  39. 39. Then gently agitate the adhesive for 20 seconds. Picture DFU
  40. 40. Evaporate solvent by thoroughly blowing with air for at least 5 sec. Avoid pooling. Picture DFU
  41. 41. Cure for at least 20 seconds. Min. Output Halogen ≥ 500 mW/cm2 Min. Output LED ≥ 800 mW/cm2 Picture DFU
  42. 42. Place increments Picture DFU
  43. 43. INCREMENTAL TECHNIQUE
  44. 44. • Shrinkage results in interfacial stresses, with the potential for debonding and/or local fracture of tissue or restorative. • Shrinkage should be minimised as far as possible. Shrinkage
  45. 45. Light-cure each increment (4 mm) Picture DFU * 10 sec for light output ≥ 800 mW/cm2, 20 sec for light output of 500 to 800 mW/cm2.
  46. 46. Polishing can be done immediately Picture DFU
  47. 47. Clinical Case
  48. 48. Clinical Case
  49. 49. Core Buildup (Pre-Op)
  50. 50. Core Buildup (Post-Op)
  51. 51. Wear Resistance • Clinical Relevance: A low wear rate means that enamel-restorative margins and contact points remain at the correct level, and that gross loss of material does not occur. It goes without saying that a low wear rate is a prerequisite for a modern composite.
  52. 52. Flexural Strength and Modulus Clinical Relevance: The flexural strength of a dental material is an important property since materials may be used in thin layers or in poorly supported edges where flexural forces occur. A high flexural strength is therefore needed.

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