Adhesivos Actuales En Odontología

due to decay or trauma, but also
strengthen and support the remaining tooth structure without removing
healthy tissue.
Dentistry has become even more exciting and fun!
2. Building a Top Quality Restorative Dental Practice
-Image
-Education
-Confidence
-Quality care
A fair fee is that fee which the patient is willing to pay without losing
their gratitude and which allows the doctor to dotheir finest dentistry.
3. Dentin Bonding
-Understand the limitations of the materials.
-Remove all bacteria.
-Modify the tissue.
-Create a manageable demineralized zone.
-Keep the dentin moist.
-Lay down a well sealed hybrid layer.
-Bond in the restoration.
The bond is formed by the interactions of all the steps, but is only as strong
as its weakest link.
The chain of Adhesion:-Tissue-Primer-Adhesive-Restoration-
©08 Brucia
4. Direct Composite Restorations
Microfils Micro-Hybrids
High Wear Resistance High Compressive Strength
High Polishablity High Shear Strength
Flexure High Cohesive Bond
Clinical Procedures
1. Take dentin shade from gingival 1/3 of the tooth. (A3, A3.5, A4)
2. Rubber dam is Mandatory.
3. Remove defective restoration and decay. Caries detector.4. Etch with 32%-37% phos. acid. Split etch technique. 15+ seconds
on enamel and 10 seconds on dentin. Wash off. Leave moist.
5. Hydrate with wetting agent. Blot dry.
6. Cover all the dentin and enamel with a one bottle system or
primer from a multiple bottle system and rub lightly on dentin
only for 15 seconds.
7. If using a highly filled bonding agent, thin out first with a dry
microbrush.8. Lightly air evaporates until movement of fluid stops and light cure
for 20 seconds.
9. Line the interproximal cavo-surface & pulpal floor with an A1 flowable
and light cure for 20 seconds.
10. Place the Hybrid composite using the dentin shade. Form the
ridges of the tooth. Cure for 40 seconds each 2mm section you
place.
11. Place pit staining to match existing teeth. Cure for 20seconds.
12. Place translucent microfil to complete your occlusal surface.
(420T) Carve the anatomy, burnish with 2FL and place a glycerin
gel on the surface prior to curing for 40 seconds from buccallingual-
occlusal.
13. Remove the rubber dam, check occlusion, adjust and polish.
14. Isolate with cotton rolls and etch composite surface and occlusal
margins for 10 seconds. Wash and dry well.
15.Place the surface sealer, air thin and cure for 30 seconds.
Consideration should always be given to the use of a Glass Ionomer
if indicated.
Closed Sandwich technique: This technique is used when a glass
ionomer is placed in an area where there is no contact with the cavosurface
of the preparation. The material is completely covered with
the restorative material. (Base and liners) A linershould be used as a
very thin covering over deep and questionable dentin surfaces. A
base should be selected anytime the material is placed thicker than
.25 mm and should be a high strength restorative material. Tooth
conditioning is not required with this technique.
Open Sandwich technique: This technique is used when a Glass
ionomer is placed in an area where there is contact with thecavosurface
on the preparation. The margin of the preparation is sealed
with the Glass Ionomer material. A restorative material should
always be used here and the tooth conditioner is indicated.
Class II Open Sandwich: Used when any part of the gingival
margin of a Class II preparation has been extended past the CEJ and
no longer has an enamel cavo-surface.
1. After placement of the matrix,condition the gingival floor with GI
conditioner for 10 seconds and wash off.
2. Place either a pure glass ionomer or a resin modified glass
ionomer interprox. to the start of enamel margins. Do not build
interproximal or occlusal contact in this material. Make sure that
there is a minimum of 2mm of the final restorative material above the
Glass Ionomer to support the marginal ridge.
3....