口腔の健康と歯の管理

概要

Dental restoration with composite materials in the posterior zone

Ion Valeriu Cherlea, Cornelia Biclesanu, Anna Maria Pangica, Cristian Bartos

The purpose of the present study is to highlight the aesthetic succes and the short time needed for shaping the occlusal surface of the composite restoration by using an silicon putty matrix as well as the reduction of the marginal leakage and the increase the quality of marginal adaptation in restorations performed using this method. Material and method. The in vivo experiment consisted in rebuilding the functional and aesthetic autonomy of the occlusal surface of posterior teeth (which initially presented carious lesions) by using an silicon putty matrix. For this purpose, a spatula was used, carrying retentions and impression adhesive. The composite was applied in layers of maximum 2 mm in order to reduce the contraction composite shrinkage during curing. As soon as the last composite layer is applied the silicon putty matrix is set upon the surface in the right position. A low sliminess sealer is applied that penetrates the surface (Fortify, Itasca), in order to minimizes microleakage and percolation. Minimum occlusal adjustments are necessary, yet they occur in very few cases. The in vitro study was performed upon 25 extracted molars and bicuspids teeth which supported restorations with resine composite materials on the occlusal surface performed using the siltek putty impression technique. These were placed in physiologic solution at 37 oC for 24 h and afterwards minimally invasive cavities and classical cavities were performed using the Black rules. The teeth were separated into 2 groups: 15 for the minimally invasive method and 10 for the classical method. Results and discussions. The operation time is reduced using this method, by eliminating the delicate shaping and finishing maneuvers (into solid material). Moreover, excessive finishing may increase the chances of damaging the composite. Due to the fact that most of the disadvantages presented by the posterior composites are frequently met in cases of large cavities, the silicon putty matrix is recommended for small restorations that present sufficient enamel for the bonding procedure and with a low risk of damage or fracture. Once the experiment is over, the extracted teeth treated through the classical method (the Black rules) present a higher impregnation degree, proving that the marginal adaptation of the filling material to the cavity edges was not perfect. The teeth treated through the silicon putty matrix, the impregnation is hardly visible, proving that from this point of view also this method is clearly more efficient. Conclusion. The technique described ensures excellent aesthetic results and minimum occlusal adjustments are necessary. The teeth treated through the occlusal matrix method, the impregnation is hardly visible, proving that from this point of view also this method is clearly more efficient.