Resin Composite Restorations II Dr.

Ghada Maghaireh  BDS, MS, ABOD 




Advantages of Resin Composite as a Posterior Restorative Material  Esthetics.  Conservation of Tooth Structure: - The preparation tends to be shallower. - The preparation tends to have narrower outline form. - The preparation has rounded internal line angles. - No extension for prevention. Advantages of Resin Composite as a Posterior Restorative Material

    

Adhesion to Tooth Structure. Low Thermal Conductivity. Elimination of Galvanic Currents. Radiopacity. Alternative to Amalgam.

Disadvantages of Resin Composite as a Posterior Restorative Material  Polymerization Shrinkage.  Secondary Caries.  Postoperative Sensitivity.  Decreased Wear Resistance.  Other Mechanical Properties: - Fracture toughness. - High degree of elastic deformation. - Coefficient of thermal expansion of composite is higher than that of tooth structure.

Disadvantages of Resin Composite as a Posterior Restorative Material

   

Water Sorption. Variable degree of cure. Inconsistent Dentin Bonding (Marginal Leakage). Technique Sensitivity. Indications of Resin Composite as a Posterior Restorative Material Esthetic should be a prime consideration. The faciolingual width of the cavity preparation should be restricted to no more than one third of the intercuspal distance and in Class II the gingival margin should be on enamel. Centric occlusal stops should be primarily on enamel. The patient should not exhibit excessive wear from clenching or grinding. The tooth should be amenable to isolation. Preventive Resin Restorations (PRR)

    

  

Limits preparation to pits and fissures that are carious. If the resultant cavity is limited to narrow and shallow opening of the fissures, a resin sealant (fissure sealant) or flowable composite is placed. If the additional tooth structure is removed, resin composite is placed in the cavity and then the remaining fissures and composite are covered by fissure sealant. Advantages of PRR Conservation of tooth structure. Enhanced esthetics. Improved seal of esthetic material to tooth structure. Minimal wear.

Good longevity. Indication and Contraindications for PRR

 

PRR is indicated when there is minimal or moderate carious fissures. PRR is not indicated for restorations that will occupy a large area of the occlusal surface.

     

 Preventive Resin Restoration (PRR)

A small round bur is used to open the fissures. Removal of carious dentin and unsupported enamel. Acid etching and bonding as with other composite restorations. If the preparation is shallow sealant or flowable composite is used. Resin composite is used to fill deep areas that extend into dentin and light cured. Sealant is placed over the resin composite and the unprepared fissures.

 Prewedging:  Compensate for the thickness of the matrix band.  Obtaining an adequate interproximal contact with the adjacent  
tooth. Protect rubber dam and gingival tissue and reduce leakage. Protect adjacent teeth from damage during preparation. Class II Composite Preparation Limited to removal of carious tooth structure. Provide access restoration placement and finishing.

 Class II resin Composite Restorations 

Preventive Resin Restoration (PRR)

  

Class II Composite Preparation

            

If there are more arrears of fissure caries lesions they should be treated separately if possible. Bevel placement is a a controversy issue. Class II Composite Restoration Placement of matrix and wedge. Acid etching: 35% phosphoric acid for 15 seconds and rinsed. Primer and adhesive application: light cure for 20 seconds. Placement of composite (incremental technique). Matrix Application

Clear and metal matrix band with Tofflemire retainer. Metal matrix is easier to place, retain their shape better, and can be burnished against the adjacent tooth. Matrix Application Good interproximal contact. Finishing Aluminum oxide disks. Fine diamond burs. Aluminum oxide impregnated rubber points and cups. Finishing

The sectional matrix system with the metal rings.




Aluminum oxide coated finishing strips.

References

Chapter # 9 of Fundamentals of Operative Dentistry