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CHEN Zhi Wuhan University School of Stomatology Operative Dentistry 3
Indication of Operative Dentistry ,[object Object],[object Object],[object Object],[object Object]
Tooth-colored restoration ,[object Object],[object Object],[object Object]
What are Tooth-colored materials? What is their working mechanism? What are the cavity preparation futures for tooth-colored restoration?
What are steps for tooth-colored restoration? What are the advantage & disadvantage of tooth-colored restoration?
Tooth-Colored Materials  ,[object Object],[object Object],[object Object]
Composite Resin Traditional composites Hybird composites Flowable composites Condensable composites Packable Universal composites
Glass Ionomer ,[object Object],[object Object]
Compomer Compomer = Compo site + Ion omer
Dental Adhesion or  Dental Bonding Adhesion is a process of solid and/or liquid interaction of one material with another at a single interface.
Enamel bonding system Enamel bongding depends on resin tags becoming interlocked with the surface irregularities created by etching.
Macrotags: form between enamel rod peripheries. Microtags: smaller tags form across  the end of each rod. Macrotags and microtags are the basis for micro-mechanical bonding.
Dentin bonding system The difficulties of dentin bonding: More water---wet bonding Lower calcification Richer organic---collagen network Smear layer
The bond strength is primarily related to micro-mechanical bonding to the intertubular dentin which occures  between tubules along the cut dentin surface.
Dentin Bonding Agent, DBA Early DBA were hydrophobic, bonded  directly to the dentin smear layer.  Bond strengths < 6MPa. Later DBA removed the smear layer but tended to over-etch dentin. Bond strengths≈10~12MPa.
DBA were chemically modified to be  more hydrophilic. Bond Strengths≈18~20MPa. Careful dentin conditioning, Coupled with hydrophilic primer, Bond Strength≈22~35MPa.
The Development of DBA Enamel etch (1955) Dentine etch (1960) Treatment of smear layer (1980) Wet Bonding technique(1990)
First generation Second generation Third generation Fourth generation: Total etch technique Fifth generation: One bottle system Sixth generation: All in one,2000 Seventh generation
Cavity Preparation Three designs of cavity preparation:  1.Conventional  2.Beveled conventional 3.Modified
Beveled conventional cavity preparations are similar to conventional preparation, in that the outline form has external, “ box-like” walls, but with  beveled   enamel margin.
Beveled enamel margin
Beveled conventional cavity designs for  Class Ⅲ, Ⅳ and Ⅴ preparations
The advantages : The ends of enamel rods are more etched The increase in etched surface results in a stronger bond Increase the retention and reduce marginal leakage and discoloration.  More esthtically
Modified cavity preparation Have neither specified cavity wall structure nor specified pulpal depth, and have enamel margins. Conserve more tooth structure.
Modified cavity preparation
Initial Clinical Procedure Local anesthesia Preparation of the operating site Shade selection Isolation of the operating site with rubber dam or cotton rolls
 
Rubber dam
Clinical Procedure Cavity preparation Acid etching enamel & conditioning dentin Matrix application Application of bonding agent Insertion of composite Finishing procedures
 
Matrix application
 
 
 
 
 
 
Final procedures
 
Cases
 
 
Conservative Operative Dentistry Minimal intervention dentistry is regards as a main stream in caries treatment in the 21 st  century.
Principles of Minimal Intervention dentistry ,[object Object],[object Object],[object Object],[object Object]
“ The day is surely coming, and perhaps within the lifetime of you young men before me, when we will be engaged in practicing preventive, rather than reparative, dentistry. ” ,[object Object]
University  Minnisota  School of Dentistry
http://202.114.104.243/jpkc/ysysbx/index.html
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