Primům non nocere!
Minimal intervention
Non invasive
Approach
<
Minimally invasive
Miniinvasive treatment
Preparation techniques
□ Mechanical
□ Chemo - mechanical
□ Kinetic
□ Hydrokinetic (Laser)
Peters MC, Mc Lean ME: Minimally invasive operative care II. Contemporary techniques and materials: An overwiev. JAdhes Dent 2001; 3:17-31.
lenka.roubalikova@tiscali.cz
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□Mechanical preparation
> Rotary
> Sonic and ultrasonic >ART
lenka.roubalikova@tiscali.cz 4
tary - special burs and diamonds
Adhesive slot preparation
A* |
Success?
1. Loupes or microscope
2. Mini instruments
3. Capsulated GIC 5. BW post op
lenka.roubalikova@tiscali.cz
Success?
Low caries risk Cooperation of the patient Intact proximal ridge D2
Caries detector
Can diferenciate carious dentin with destroyed and intact collagen network
lenka.roubalikova@tiscali.cz
Chemomechanical preparation
Chemomechanical preparation
SSodium hypochlorite + triaminoacids Removal of carious dentin, non active in enamel GIC is the suitable material
lenka.roubalikova@tiscali.cz
Rafique S, Banerjee A, Fiske J. Clinical trial of an air-abrasion/Carisolv gel regimen for restorative treatment for dentally anxious patients. Caries Res 2002; 186 (Suppl.3)36:39.
M
Kinetic preparation
• Principally sandblasting
• Irregular cavosurface margin
• No excavation of carious dentin
• Suitable for composite materials
Ultrasound in dentistry
Piezoelektric generators
10 W/cm2
lenka.roubalikova@tiscali.cz
Ultrazvuk v zubním lékařství
Oral hygiene - prophylaxis Subgingival treatment Preparation of cavities
Endodontics
Prosthetics
Surgery
lenka.roubalikova@tiscali.cz
Ultrazvuk v zubním lékařství
• Odstranění biofilmu a zubního kamene -profesionální hygiena
Robustní koncovky pracovní řady streamline. Orientace:
Magnetostrikční: Delší osa elipsy(osmičky) směřuje tangenciálně k povrchu zubu Piezoelektrické: Dráha pohybu koncovky je tangenciální k povrchu zubu
lenka.roubalikova@tiscali.cz
Preparation
Oscillation of the instrument
No risk of the damage of the neighborough tooth
Mini and microcavities, slots and tunnels, preparation of cavosurface margins
lenka.roubalikova@tiscali.cz
Preparace kavit
33
reparation in enamel
36
Preparation in enamel
Preparation in dentin
39
Proximal caries
Sonická aproximální preparace
42
LASER
• LIGTH AMPLIFICATION BY STIMULATED EMISSION OF RADIATION
Maiman 1960
Basov, Prokhorov, Townes,
lenka.roubalikova@tiscali.cz
Light
Elektromagnetic wave
- Wavelenght -Amplitude
- Photons
lenka.roubalikova@tiscali.cz
Natural light
Hickel, 2004
Polychromatic Divergent ~ Incoherrent
lenka.roubalikova@tiscali.cz
Laser light
Active medium
> Argon - Fluor UV
> Krypton- Fluor UV
> Helium - Kadmium UV, VIS
> Argon VIS
> Rubin VIS
> Nd:YAG VIS,IR
> Helium-Neon VIS, IR
> Diode lasers VIS, IR
> Erbium IR (Er:YAG, Er,Cr:YSGG)
> Oxid uhličitý IR
lenka.roubalikova@tiscali.cz
Er:YAG laser
Active medium: Erbium Yttrium Aluminium - Garnet
Wavelength: 2940 nm
Er,Cr:YSGG laser
Active medium: Erbium a Chromium Yttrium - Scandium - Gallium - Garnet
Wavelength: 2780 nm
Principle of action
Mechanismus účinku
Indications
> Preparation
> Mucogingival surgery ^Endodontics >Analgezia, biostimulation
Pulse regime
Preparation
Cavities
Adhesive preparation - laser etching
lenka.roubalikova@tiscali.cz
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Results
Enamel
Results
ntin
7.0kV X*
ISI
LEI
5.0kV X5.000
1 fan
WD 8.6mm
Dalikova@tiscali.cz
Roubalíkova L, Neděla V., Polenik P.: Adhesive Preparation. A Comparison of Various Methods ESOLA, Bruges, 2006
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63
Laser- benefits
> Minimally invasive treatment
> No anaesthesia
> No smear layer
> Dentine tubules are open
> Antimicrobial effect
lenka.roubalikova@tiscali.cz
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