Composites for class ii cavities

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Composites for class ii cavities

  1. 1. COMPOSITES FOR CLASS II CAVITIES SEMINAR-DEPARTMENT OF CONSERVATIVE DENTISTRY& ENDODONTICS VESTA ENIDLYDIA .R III BDS CSICDSR-MADURAI
  2. 2. [Type text] 2 Dentalcompositeresins are types of synthetic resins which are used in dentistry as restorative material or adhesives. Synthetic resins evolved as restorative materials since they were insoluble, aesthetic, and insensitive to dehydration and were inexpensive. It is easy to manipulate them as well. Composite resins are most commonly composed of Bis-GMA monomers or some Bis-GMA analog, a filler material such as silica and in most current applications, a photoinitiator. Dimethacrylates are also commonly added to achieve certain physical properties such as flowability. Further tailoring of physical properties is achieved by formulating unique concentrations of each constituent.
  3. 3. [Type text] 3 Historyof use Initially, composite restorations in dentistry were very prone to leakage and breakage due to weak compressive strength In the 1990s and 2000s, composites were greatly improved and are said to have a compression strength sufficient for use in posterior teeth. Today's composite resins have low polymerization shrinkage and low coefficients of thermal shrinkage, which allows them to be placed in bulk while maintaining good adaptation to cavity walls. The placement of composite requires meticulous attention to procedure or it may fail prematurely ADA STATEMENT ON POSTERIOR RESIN-BASED COMPOSITES 1.composites used successfully till date in o CLASS V RESTORATIONS.
  4. 4. [Type text] 4 o RESTORINGESTHETICALLYIMPORTANT AREAS. o IN PATIENTSALLERGICOR SENSITIVE TO METALS. 2.other places where composites can be used are o PIT AND FISSURESEALING. o PREVENTIVERESIN RESTORATIONS. o INITIALCLASS I AND II LESIONS.  MODERATE-SIZED CLASS I AND II RESTORATIONS 3.LITERATURE DOES NOT SUPPORT THE SUCCESFULL USE IN o TEETHWITHHEAVYOCCLUSALSTRESS. o IN SITESTHAT CAN’T BE ISOLATED. IN PATIENTSALLERGICTO RESIN-BASED COMPOSITES.
  5. 5. [Type text] 5 4.FUTURE RESEARCH IN COMPOSITESSHOULD ADDRESS o REDUCTIONIN POLYMERIZATION SHRINKAGE. o IMPROVED DENTIN/ENAMELBONDING TECHNIQUES. o IMPROVED PLACEMENT AND INSTRUMENTATION TECHNIQUES. o IMPROVED CURING METHODS. o CONTACT WEAR BEHAVIOR. o POLYMERIZATIONINITIATORS. o ALTERNATIVEMATRIX SYSTEMS. o MORE EXTENSIVERESTORATIONS?? CASE SELECTION  Cavity preparationdesign  Locationof margin
  6. 6. [Type text] 6  Locationof restoration  Sizeof restoration  OCCLUSIONCONCERNS/ANTAGONISTICCUSP:  o GREATLYAFFECTS DEGRADATION OF COMPOSITE. o INCREASEDLOCALIZEDWEAR ON THE COMPOSITE SURFACE WITHINCREASED CONTACT AREA. o INCREASEDGENERALIZED WEARON THE CONTACT FREEAREA. o BULK FRACTURE AND MARGINAL DETERIORATION. ANTAGONISTICCUSP: o PRE-OP: USE OF ARTICULATINGPAPER. o DESIGNOUTLINE FORM TO AVOID CONTACT AREA.
  7. 7. [Type text] 7 o MODIFYTHE OPPOSINGCUSP TO REDIRECT THE CONTACT AREAAWAY FROM RESTORATION. o ENAMELOPLASTYOF OPPOSINGCUSP TO FLATTENTHE OCCLUSALLOAD OVER A WIDERAREA. MATERIAL OPTIONS  HYBRIDRESIN  MICROFILL ED RESIN  HYBRIDRESIN INTERNAL& MICROFILL RESIN ON OUTER 1 MM.  PACKABLERESIN  PACKABLERESINWITHMICROFILLON OUTER 1 MM. CLINICAL TECHNIQUE ISOLATION RECOMMENDATIONS
  8. 8. [Type text] 8  RubberDam Isolationis Mandatory: o Failureto maintaina dryfieldwillresultin clinicalfailure. o Preventionof moisturecontaminationand protectionof gingivaltissues is of paramount importance. o Selectshadebeforerubberdam application.  Dentinshadeup to the DEJ level.  Incisal or enamelshadefor finalincrement. PRE-WEDGING  Gains interproximalseparationto facilitatetight contactarea.  INITIAL: 90 um movement.  AFTER 30 SECONDS: o 30 um is lost.  90% RECOVERY: within30 seconds removalof wedge. CAVITYPREPARATION
  9. 9. [Type text] 9  ADHESIVE PREPARATION FOR POSTERIOR COMPOSITES  DIFFERSFROM TRADITIONAL AMALGAM PREPARATIONSIN MANY WAYS.  PREPARATION IS SHALLOWER.  RETENTIONIS PROVIDEDTHROUGH BONDING  PREPARATION IS NARROWER: o 1. LESS OCCLUSALCONTACT AREA. o 2. REDUCESWEAR. o 3. DECREASES AFFECT OF POLYMERIZATION SHRINKAGE. o 4. IMPROVED MARGINALINTEGRITY. o 5. LESS CUSPALDEFLECTION.  PREPARATION HAS ROUNDEDINTERNALLINEANGLES: o 1. CONSERVES TOOTHSTRUCTURE.
  10. 10. [Type text] 10 o 2. DECREASES STRESSCONCENTRATION. o 3. ENHANCES RESINADAPTATION DURING PLACEMENT.  NO EXTENSIONFORPREVENTION: o 1. OCCLUSALSURFACEIS INVADED ONLY IF CARIES DICTATES IT. o 2. TREAT ADJACENT PITSAND FISSURES WITHSEALANTS. PROXIMAL BOX PREPARATIONCONCERNS  SLOT PREPARATIONS: o MECHANICALRETENTIONISN’T IMPORTANT. o DON’T EXTEND THEPREPARATION BEYOND THEMARGINAL RIDGEBY MORE THAN 2 MM.
  11. 11. [Type text] 11 GINGIVAL MARGIN CONCERNS  SLOT PREPARATION OR CONVENTIONAL CLASSII PREP: o GINGIVALFLOOR EXTENDED ONLY TO DEPTHOF CARIOUSLESION. o CONSERVEENAMELFOR BONDING AND MICROLEAKAGEPREVENTION. OCCLUSAL MARGIN OF PREPARATION o BEVELED OCCLUSALCAVOSURFACE MARGIN: o SIGNIFICANTLYINCREASES THEWEAR RATE COMPAREDTO CONVENTIONAL BUTT JOINT CAVOSURFACEMARGINS. o WHY? THEBU-LIDIMENSION IS INCREASEDAND INFLUENCES THE AFFECT OF THE ANTAGONISTICCUSP PULPAL PROTECTION
  12. 12. [Type text] 12  Postoperativesensitivity concerns: o effects of polymerizationcontractionand/or marginalleakagewithbacterialinvasion. o Hermetically sealthe dentinwithyourchoiceof dentinbonding agent material. o Placea light curableresinmodifiedglass ionomer cement that has the fluoridereleasingproperties you may desire. DENTIN/ENAMEL BONDING  AnotherClinicalDecisionto Make: o yourchoiceof one of the currently availabledentin bondingagents followingthe manufacturer’s instructions. CRITERIA FOR MATRICES  RE-ESTABLISHCONTOUR  FORM POSITIVECONTACT  SEAL GINGIVALMARGIN  ALLOW ADEQUATE BULK OF MATERIAL
  13. 13. [Type text] 13  LIMITEDTHICKNESS  PRODUCESMOOTHSURFACE CRITERIA FOR MATRICES  PERMIT NON-DISRUPTIVEWITHDRAWAL  MUST AVOIDTOOTH DISTORTING PRESSURES  MUST BE EASY TO PLACE  ALLOW FOR A VARIETY OF RESTORATIVE MATERIALS COMPOSITE PLACEMENT TECHNIQUES  1.SEGMENTALPLACEMENT: < 5.0 MM.
  14. 14. [Type text] 14 o 1. FLOWABLERESIN(0.5-1.0MM LAYER) o 2. DENTINSHADEOF PACKABLERESIN. NO MORE THAN 3.0-3.5MM INCREMENTS. o 3. TINT PLACEMENT (OPTIONAL). o 4. ENAMELSHADE(UNIVERSAL HYBRID)  2.BULKFILLTECHNIQUE: o A MAJOR CLAIMOF PACKABLE COMPOSITE MANUFACTURERS. o Incrementsshouldbe no greaterthan2mm to obtaina uniformand maximumcure. o Increasecavitydepthresultedin decreased effectivenessof polymerizationforall exposure times. o Increasedexposuretimeresultedin an increased hardnessratio and effectivepolymerizationat depths of 3-4 mm.
  15. 15. [Type text] 15 THREE-SITED LIGHT CURING TECHNIQUE  FIRSTINCREMENT: o CURED THROUGHTHELIGHT- REFLECTINGWEDGE IN A GINGIVAL- PROXIMALDIRECTION.  LARGER 2ND and 3RD INCREMENT: o CURED FROM BUCCALAND LINGUAL. o ENSURESSHRINKAGE VECTORS TOWARD THECAVITY MARGINS.  FINALINCREMENT:
  16. 16. [Type text] 16 o ADDED TO THE OCCLUSALASPECT. FINISHING PROCEDURES  12-B BLADETO REMOVEINTERPROXIMAL GINGIVALEXCESS.  FINE-DIAMOND FINISHINGSTRIPS.  ALUMINUM OXIDEFINISHINGDISCS.  CARBIDE FINISHINGBURS.

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