lroubal@med.muni.cz 1 Adhesive dentures  Fixed dentures, adhesive cementation  Veneers, inlays onlays, adhesive bridges, adhesive splints with the replacement of one tooth.  Materials: plastic, ceramics, metal alloy lroubal@med.muni.cz 2 Adhesion  Adhesive  Adherend lroubal@med.muni.cz 3 Adhesion  Mechanic  Specific lroubal@med.muni.cz 4 Adhesion  Mechanical Rough surface lroubal@med.muni.cz 5 Adheze  Specifická Fyzikální Chemická lroubal@med.muni.cz 6 Adheze  Specific Physical – intermolecular forces van der Waals forces hydrogen bridges … lroubal@med.muni.cz 7 Adhesion  Specific Chemical covalent ionic metal lroubal@med.muni.cz 8 Adhesive treatment of surfaces in dentistry  Sandblasting  Etching  Elektrolytic  Laser  Plasma coating  Silanisation lroubal@med.muni.cz 9 Adhesive treatment  Rough surfaces  Increases surface energy  Improves penetration of liquids to the surface  Combination lroubal@med.muni.cz 10 Adhesion of dental materials Composite materials - micromechanically Adhesives– mechanic, specific Glassionomers and polykarboxylates - specifick Composites lroubal@med.muni.cz 12 Mechanic lroubal@med.muni.cz 13 Adhesive system Mechanic lroubal@med.muni.cz 14 Mikronetěsnost Nanonetěsnost . v lroubal@med.muni.cz 15 Conditioner Demineralization Increases surface energy lroubal@med.muni.cz 16 Primer Open the collagen network and keep it open lroubal@med.muni.cz 17 Bond  Penetrate into the collagen network and itno the etched enamel lroubal@med.muni.cz 18 Etching Washing Priming Bonding Etching Washing Priming a bonding Selfetching priming Bonding Selfetching bonding Adhesive systems lroubal@med.muni.cz 19 Problems Quality of hard dental tissues Collaps of the collagen network Contamination of the surface Expiration lroubal@med.muni.cz 20 Cementation  Quality of the restoration (crown, inlay..)  Cement  Size and quality od the surfaces for adhesion lroubal@med.muni.cz 21 Outer or inner taper retentiong/mm2 Angle of onvergency Rau G. 1994 lroubal@med.muni.cz 22 Cements  Zinkoxidphosphate cement  Zinkoxidcarboxylate cement  Glassionomer cement  Resin modified glassionomer cement  Composite cements lroubal@med.muni.cz 23 Adheze není všude!!!! Čím delší čep, tím lepší retence!!! lroubal@med.muni.cz 24 Composite cements  Composite materials  Lower viscosity  Chemically or dual curing. lroubal@med.muni.cz 25 Adhesive cements Two component materials lroubal@med.muni.cz 26 Variolink (Ivoclar-Vivadent) Calibra (Deentsply de Trey) Bifix (VOCO) Ena Cem (Micerium) Photoiniciation - primary lroubal@med.muni.cz 27 Chemically initiation - primary Multilink, Multilink Automix (Ivoclar Vivadent) Relyx (3M Espe) lroubal@med.muni.cz 28 Chemically cured only Panavia 21 (Kuraray) Dyract Cem (DENTSPLY De Trey) lroubal@med.muni.cz 29 Adhesive systems for composite cements  Total etch  Self etch  No etch Compatibility !!! lroubal@med.muni.cz 30 Selfetching cements RelyX™ Unicem (3m Espe, Německo) Multilink Sprint (IvoclarVivadent) lroubal@med.muni.cz 31 lroubal@med.muni.cz 32 lroubal@med.muni.cz 33 lroubal@med.muni.cz 34 lroubal@med.muni.cz 35 lroubal@med.muni.cz 36 lroubal@med.muni.cz 37 lroubal@med.muni.cz 38 lroubal@med.muni.cz 39 lroubal@med.muni.cz 40 Adhesive dentures with metal framework lroubal@med.muni.cz 41 Preparation Preparation in enamel (0,3 -0,5 mm) Removal of old filling Adhesion and smaller retention area. lroubal@med.muni.cz 42 Indikation of adhesive dentures with metal framework 1 tooth replacement in posterior area 1 -2 teeth replacement in anterior area Conditions for adhesive dentures must be fullfilled lroubal@med.muni.cz 43 Pros and cons  Minimal preparation  Compromised aesthetics  Risk of reccurent caries  Semipermanent solution lroubal@med.muni.cz 44 Maryland bridge lroubal@med.muni.cz 45 Adhesive broidge with metal framework horizontally stabilized lroubal@med.muni.cz 46 Adhesive splint with metal framework lroubal@med.muni.cz 47 Adhesive connection Metal Cement Enamel Sandblastiong Silanization Etching Adhesive lroubal@med.muni.cz 48 lroubal@med.muni.cz 49 Pontic - ceramics Pontic – compsite resin lroubal@med.muni.cz 50 lroubal@med.muni.cz 51 lroubal@med.muni.cz 52 Selfetching cements Non metallic adhesive dentures Kompozit Keramika Inlaye, inlayové můstky Indications 1. Replacement of a parti of tooth or entire tooth – aesthetics reasons Contraindications  Bad oral hygiene  Bad intermaxillar relations  Subgingival defects  Bruxism  Bad quality of hard dental tissues preparation  Divergency cca 6°  No bevel  Smooth borders  Thickness of the material 1,5 – 2 mm. Antagonal impression  Alginate Registration of intermaxillary relations Wax or special procedures Temporary (Fermit, Clip)  Temporary inlay (Systemp - Vivadent, Protemp - Espe) Inlay bridges  Material: Composite Ceramics lroubal@med.muni.cz 75 Inlay bridge  Indications: Small defects, good oral hygiene. Adhesive cementation. Reinforcement od composite bridges with FRC. lroubal@med.muni.cz 76