Composites in posterior teeth



•All pit and fissure restorations.
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•They are assigned in to three groups.
•R. on occlusal surface of premolars and molars
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•R. in foramina coeca – usually on occlusal two thirds
•of the facial and lingual surfaces of molars.
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•R.on lingual surface of maxillary incisors.
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3R7 I-1_03
•Trvanlivoist
•Longevity of fillings

§ Infractions of marginal ridge
§  Corrosion
§  Bad aesthetics
 Amalgam - disadvantages
F_Surefil_17 F_Surefil_22

§ Easier to place
§ Good mechanical properties esp.
§  Price
 Amalgam - advantages
F_Surefil_17 F_Surefil_22

Indications
* Moderate to large restorations
* Restorations that are not in highly aesthetics areas
* Restorations that have heavy occlusal contacts
* Restorations that cannot be well isolated
* Restorations that extend onto the root surface
* Foundations
* Abutmjent teeth for removable partioal dentures
* Temporary or caries control restorations.
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Contraindications
* Aesthetically prominent areas of posterior teeth
* Small moderate classes I. that can be well isolated

Materials: Amalgam, composite.
Amalgam:
Pertinent material qualities and propeties
Strength
Longevity
Ease of use
Clinically proven sucess

Clinical technique
* From the occlusal surface using the fissure bur (or diamond burs, see below).


Outline
* Ideal outline includes all occlusal pits and fissures. If crista transversa od obliqua are no
affected, it is recommended not to prepare them.

Resistance principles
* Keep the facial and lingual margin extensionsas minimal as possible between the central groove
and the cusp tips.
* Extending the outline to include fissures, thereby placing the margins on relatively smooth
sopund tooth structure.
* Minimally extending into the marginal ridge without removing dentinal support.
* Eliminating a weak wall of enamel by joining teo outlines that come close together
* Enamel.
–Nevel leave the enamel undermined
* All corners are round, the bottom smooth.

Retention principles
* Prepare the box – the bottom is in dentin
* Undercuts can be prepared, the proximal ridges must not be weakened!

Removal of carious, infected, dentin and remaining defective enamel.
* Spoon excavator or a slowly revolving , round carbid bur of appropriate size.


§  Adhesive material – good connection
•   without any gap
§ Excellent aesthetics
§
Composite- advantages
F_Surefil_17 F_Surefil_22

§ Good isolation is necessary
§  Technique sensitive treatment
§  Price
Composite - disadvantages
F_Surefil_17 F_Surefil_22

Indications
* Aesthetically prominent areas of posterior teeth
* Small  - moderate classes I. that can be well isolated
* Good level of oral hygiene is necessary

 Contraindications
* Moderate to large restorations
* Restorations that are not in highly aesthetics areas
* Restorations that have heavy occlusal contacts
* Restorations that cannot be well isolated
* Restorations that extend onto the root surface
* Abutment teeth for removable partioal dentures
* Temporary or caries control restorations.
*

Materials: Amalgam, composite.
Amalgam:
Pertinent material qualities and propeties
Strength
Longevity
Ease of use
Clinically proven sucess

Clinical technique
* From the occlusal surface using the fissure bur (or diamond burs)


Outline
* Outline includes the caries lesion only


Retention principles
* Prepare the box or deep dish – the bottom is in dentin
* Do not prepare any undercuts!
* Do not bevel enamel, finish the border with diamond bur inly.

Removal of carious, infected, dentin and remaining defective enamel.
* Spoon excavator or a slowly revolving , round carbid bur of appropriate size.


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•  Postoperative sensitivity
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•ditching
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• marginal
•discoloration
•gap
•  cracks
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•Versluis 2000
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•Secondary caries

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•Polymerization shrinkage

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•Polymerization shrinkage

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•Surface of adhesion/free surface of the filling
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•1/1  and less is optimal
•C - factor

c1 c3 c5
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•  Postoperative sensitivity
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•ditching
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• marginal
•discoloration
•gap
•  cracks
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•Versluis 2000
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•Secondary caries

lroubalikova@gmail.com
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•Monomer          Polymer
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•Light
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•Polymerization

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•Pre –gel
•Gel point
•Post -gel
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•        Chemicky iniciovaný kompozit
434343
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•43mm
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•42mm
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•                     Fotokompozit
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3,2mm
                   57 mm
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•3mm
•8,5mm

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•Fotokompozit
•102mm
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•48mm
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Forces of polymerization shrinkage
depend on
-Composite material (content of filler)
-Geometry of the cavity (C-factor)
-Placement of the composite
-Mode of polymerization

Forces of polymerization shrinkage
depend on (polymerization stress)
•Composite material (content of filler)
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•High content of the filler causes bigger stress
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•Flowable composites – low stress
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•polymer

Forces of polymerization shrinkage
depend on
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•Geometry of the cavity (C-factor)

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•Polymerization shrinkage

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•Polymerization shrinkage

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•Surface of adhesion/free surface of the filling
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•1/1  and less is optimal
•C - factor

c1 c3 c5
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•                              2
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•                                                                       1

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•  Postoperative sensitivity
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•ditching
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• marginal
•discoloration
•gap
•  cracks
•
•Versluis 2000
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•Secondary caries

Forces of polymerization shrinkage
depend on
-Placement of the composite:
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-Create the first layer thin, flowable can be used
-Place th material in increments with respect of the C-factor of each layer

•Placement of the material



Forces of polymerization shrinkage
depend on
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-Mode of polymerization
•Phases
-Pre-gel
-G-point
-Post -gel

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•Monomer
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•Polymerization
•Polymer

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•Pre –gel
•Gel
•Post -gel
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•Pre gel phase should be long – soft start !!!!

Marginal adaptation
*  Placement of composite material
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* Dry operating field
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* Adhesive systems
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I-2_09

flow1
•Flow materiály - význam
1.Vyrovnání zátěže (protistresové vlastnosti)
2.Vyblokování podsekřivin
3.Adaptace ke stěnám
4.Estetické důvody
5.Ochrana adheziva
6.
•Temperovaný kompozit

Úzký svislý
•= konfigurační faktor
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•Plocha adheze / volný povrch výplně
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Úzký svislý

Adhesives
* Acid etching technique
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* Selfetching adhesive systems
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Adhesives
* Acid etching technique
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•Etching
•Washing
•Priming Bonding

Adhesives
* Selfetching adhesive systems
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•Priming
•Bonding
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Adhesives
*  Active and passive bonding
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•Active – rubbing with microbrush
•Passive – without any rubbing

ena



enaperi enaintra



adhese1



adheSe5lei enaperi



smearlayer2



DETAILZAS



dentin1 tagskorokalne



dentinbezsmearlayer1



halasovasendvic tekut8 flow1



•
•





 Adhesive preparation in a fissure



  Adhesive preparation



 Preparation of enamel borders
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•Preparation
•                45°

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•Next to cusp
•50-60°,
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•Preparation
•30 - 40°
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•?
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 Cervical borders
• In enamel
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• No bevel
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Cervical borders
•In dentin

Interproximal borders
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 Preparation technique



Oscillating instruments



malakavitaokluze
•Minikavity
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•Otevírání fissur
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oklplocha peceteni5 peceteni6 logosov

Ceram-X Duo_Class II_01 Ceram-X Duo_Class II_05 Ceram-X Duo_Class II_07 Ceram-X Duo_Class II_09
 Composite filling class II.
Contact point

2trida1 optramatrice bkontaktu6
•Contact point
•Contact area

Class II. and contact point
* Matrix band + matrix retainer
-Metal band
-Plastic band (polyester)
•Without matrix retainer
* Sectional matrices with separator

matricepalodontinsitu3 palodontkleste1 palodonkleste



model2tr2 modeloptra2







































slot1 slot2
•Sedelmayer
slot3 slot4
•Adhezivní slotová preparace

Approximal Caries



Approximal Caries



interprox1 Kopie interproxim5 Kopie interproxim4 interprox3



tunel1 tunel2 tunel3
•Tunnel preparation
logosov

tunel1a tuneldetail1 logosov



1202161355_8 tunelpovyplni tunel logosov



tunely tunelyhotovo logosov



tunel1 tunel2
•Success?
•Low caries risk
•Special smal instruments
•Magnification
•BW post op

*
postrusek3 postrusek4 postrusek5


*
postrusek7 postrus8 postrusek92


*
postrusek93 VYLEŠTĚNO