RU2529631C1 - Method for partial substitution of colour-adapted photocomposite dental restoration - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medicine, particularly to dental therapy, and aims at using for correcting photocomposite restorations. Photocomposite surface and hard tooth tissues are exposed to air-abrasive processing by the low-abrasive cleansing glycine powder Clinpro Prophy Powder. Air Flow sandblast tip is used. Tip cannula is inclined at no more than 30° to the processed surface to enlarge a contact area of the abrasive flow with the surface and reducing the exposure time.

EFFECT: by restoration based on minimal intervention, method enables reducing the time of treatment, providing high adhesive values between old and new composite and preserving hard tooth tissues as much as possible.

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Description

The invention relates to medicine, namely to therapeutic dentistry, and can be used for the correction of photocomposite restorations with chips of the photocomposite.

The development of adhesive technologies has a dominant influence on modern concepts in restorative dentistry, the main principles of which are the preservation of intact dental tissues and the reduction in the number of necessary interventions. The use of modern substitute photocomposite materials does not require mechanical retention, making minimally invasive treatment possible. However, dynamic environmental conditions of the oral cavity, such as changes in the pH of saliva, abrasion of food and the rate of temperature changes, can destroy the composite [2]. In vivo aging of a composite entails various phenomena, including microdropping, wear (surface abrasion), discoloration, formation of an edge gap, delamination or fracture of the composite, which ultimately leads to the need to replace the restoration.

Complete replacement of the restoration is the most common procedure in dental practice. At the same time, this approach in most cases can be considered as excessive treatment, since a significant part of the restorations is clinically and radiologically intact, and the complete removal of the replacement material inevitably leads to excessive grinding of healthy hard tissues, thinning of the walls of the tooth and sometimes to damage to the pulp. For this reason, restoration of an existing restoration by replacing layers of restoration material can be considered as an alternative to complete replacement.

The strength of adhesion between the photocomposites during restoration correction decreases with time by 25-80% compared with the initial indicators [6]. Therefore, partial replacement methods are needed to ensure the long-term stability of the restoration when functioning in the oral cavity. Achieving the optimal adhesive bond of the composite-composite depends on the method of surface preparation and the properties of the substitution materials used [4, 5].

There is a method of partial replacement of a photocomposite tooth restoration [1], which includes preparing the surface of the photocomposite and hard tooth tissues using a coarse-grained diamond bur, applying a Clearfil Protect Bond self-etching adhesive (Kuraray, Japan) and restoring the photocomposite with a new portion of the same material. This method provides high adhesion between photocomposites (up to 98 MPa). The disadvantage of this method is the difficulty of excision of the existing photocomposite restoration, matching in color with the hard tissues of the tooth, without damage [1]. This is important to consider in those clinical situations when the cavity is formed not only by the material of the old restoration, but also by the hard tissues of the tooth.

The objective of the invention is to provide a method for partial replacement of color-adapted photocomposite restorations, ensuring maximum preservation of hard tooth tissues.

The objective is achieved in that a method for partially replacing a color-adapted photocomposite tooth restoration involves air-abrasive treatment of the surface of the photocomposite and hard tooth tissues with a low abrasive cleaning powder based on Clinpro Prophy Powder glycine, which has a minimal damaging effect on the surface of the photocomposite and hard tooth tissues. In this case, sand blasting tips of the Air Flow series (EMS, Switzerland) are used.

The cannula of the tip is placed at an angle of no more than 30 degrees to the surface to be treated to increase the area of contact between the abrasive flow and the surface and reduce the exposure time.

The composition of the Clinpro Prophy Powder cleansing powder (3M ESPE, USA) provides a gentle effect on the enamel and cement of the tooth root during gum recession. After sandblasting with Clinpro Prophy Powder cleaning powder, defects of 1-2 microns in depth appear on the treated surface (after using cleaning powder based on sodium bicarbonate and calcium carbonate, defects with a depth of 5-10 microns) [3].

Using Clinpro Prophy Powder cleaning powder (3M ESPE, USA) for air-abrasive treatment of the surface of the photocomposite and hard tooth tissues is a rational solution when surface preparation is not required (for example, when the photocomposite is chipped on occlusal, contact, vestibular, oral surfaces of the tooth), since this powder has a minimal damaging effect on the surface of the photocomposite and hard tooth tissues (minimal abrasiveness <63 μm).

The tips of the AIR FLOW series (EMS, Switzerland) were chosen as a tool for air-abrasive treatment of the surface of the photocomposite and hard tissues of the tooth, since the use of these tips leads to less deep defects on the surface of the photocomposite and hard tissues of the tooth compared to Prophyflex tips (Ka Vo , Germany), regardless of the abrasive powder used [7].

The method is as follows.

The surface of the photocomposite and hard tissues of the tooth is subjected to air-abrasive treatment using Clinpro Prophy Powder glycine cleansing powder (3M ESPE, Germany) and the AIR FLOW tip, positioning the tip at an angle of 30 ° to the surface to be treated. A self-etching system, for example Contax (DMG, Germany), is used as an adhesive. The introduction of the composite is carried out in layers with photopolymerization of each layer.

Example. Patient K., 29 years old, applied for cleavage of the contact surface of 21 tooth restoration, with complaints of aesthetic and functional defects. When examined in the oral cavity on the approximate surface of the restoration of 21 teeth, a cleavage of the photocomposite was revealed (Black class IV), the borders of the restoration were not determined during probing, and no regional staining was detected. The unsatisfactory condition of the contact point was noted. According to the claimed method, a partial replacement of the material of the previously performed restoration was carried out. For this, air-abrasive treatment of the surface of the photocomposite and hard tooth tissues with Clinpro Prophy Powder powder (3M ESPE, Germany) was carried out using an AIR FLOW handy 2+ sandblasting tip (EMS, Switzerland). The tip cannula was positioned at an angle of not more than 30 ° to the surface to be treated. Then Contax self-etching adhesive was applied (DMG, Germany). The adhesive was photopolymerized using a halogen lamp (Megalux®, Mega-physic, Germany) for 20 s. The recovery was carried out using a Filtek Z550 photocomposite (3M ESPE, USA) with photopolymerization of each layer for 40 s. Excess material was removed with finishing burs. The restoration surface was polished with rubber heads of various abrasiveness, Occlubrush brushes and Soft-Lex discs (Kerr, USA). During follow-up examinations after 3, 6 and 12 months, chips, cracks, discoloration and marginal fit were not observed.

The technical result of the method:

- the expansion of the arsenal of funds for repeated restorations of teeth;

- maximum preservation of hard tooth tissues;

- reduction of treatment time due to partial or complete preservation of previously performed restoration;

- optimal adhesion of the photocomposite (70-92 MPa) with hard tissues of the tooth and with the photocomposite of the previously performed restoration;

- ensuring a tight marginal fit (according to the results of electron microscopic studies).

The proposed method for partial replacement of a color-adapted photocomposite tooth restoration has shown high efficiency in clinical conditions (stability of repeated restoration when functioning in the oral cavity according to clinical observations evaluated according to modified criteria of the American Dental Association).

Thus, the method allows for repeated restorations according to the principle of minimally invasive intervention and ensures maximum preservation of tooth hard tissues.

Information sources

1. Kuznetsova L.A. Clinical and laboratory research of partial replacement of composite restorations: dis. ... cand. honey. Sciences: 01/14/14: protected 01/29/10: approved. 06/04/10. Krasnoyarsk, 2010.146 s.

2. Akova, T. Effect of food-simulating liquids on the mechanical properties of provisional restorative materials / T. Akova, A. Ozkomur, H. Uysal // J. Dent. - 2006. - Vol.22. - P.1130-1134.

3. Atomic force microscopy in vitro study of surface roughness and fractal character of a dental restoration composite after air-polishing / M. Salerno, L. Giacomelli, G. Derchi et al. // Biomed. Eng. Online - 2010. - No. 9. - P.59.

4. Composite-to-composite microtensile bond strength in the repair of a microfilled hybrid resin: effect of surface treatment and oxygen inhibition / F. Papacchini, S. Dall'Oca, N. Chieffi et al. // J. Adhes. Dent. - 2007. - Vol. 9, No. 1. - P.25-31.

5. Effect of surface conditioning methods on the microtensile bond strength of resin composite to composite after aging conditions / M. Ozcan, S.H. Barbosa, R.M. Melo et al. // Dent. Mater. - 2007. - Vol.23, No. 10. - P.1276-1282.

6. Effects of surface conditioning on repair bond strengths of non-aged and aged microhybrid, nanohybrid, and nanofilled composite resins / M. Rinastiti, M. Ozcan, W. Siswomihardjo et al. // Clin. Oral Investig. - 2011. - Vol.15, No. 2. - P.625-633. (5)

7. Influence of air-polishing devices and abrasives on root dentin-an in vitro confocal laser scanning microscope study / M. Pelka, S. Trautmann, A. Petschelt et al. // Quintessence Int. - 2010. - Vol.41, No. 7. - P. 141-148.

Claims (1)

A method of partially replacing a color-adapted photocomposite tooth restoration, including partial removal of the old restoration material, applying a self-etching adhesive to the treated surface and applying a photocomposite, characterized in that the partial removal of the old restoration material is carried out by air-abrasive processing of the surface of the photocomposite and hard tooth tissues on a low-basis tooth Clinpro Prophy Powder glycine with minimal surface damage l of the composite and hard tissues of the tooth using sandblasting tips of the Air Flow series (EMS, Switzerland), and the Contax self-etching system (DMG, Germany) is used as a self-etching adhesive.