Adobe Systems Faculty of medicine, Dpt of restorative dentistry, ass.prof. L. Roubalikova 1 Restorative dentistry III. 3rd lecture – inlays, veneers Indirect reconstructions [USEMAP] Adobe Systems Rigid fillings – inlays, onlays •The material is rigid (already cured) Metal alloy, composite, ceramics. [USEMAP] Adobe Systems Inlays made of the metal alloy (precious alloys) ̶Manufactured in a dental lab ̶ ̶Direct or indirect method -Direct method rarely (class I. only) -Indirect method (most cases) ̶ [USEMAP] Adobe Systems Inlay ̶Crown inlay - a part of a clinical crown is replaced ̶ ̶ ̶Root canal inlay - The inlay is cemented into the root canal and replaces a crown (abutment tooth – stump, snag) ̶ [USEMAP] Adobe Systems Crown inlay Material ØMetal Alloys ØComposit ØCeramics inlayreciproke kotveni halasovasendvic [USEMAP] Adobe Systems Crown inlays Indications lA big loss of dental tissues (cusps replacemen lNext to the crowns and bridges made of metal alloy [USEMAP] Adobe Systems Inlays made of the metal alloy Indications lLarge defects (i.e. – cusps replacement) lLarge interdental spaces lNext to crowns and bridges made of metal alloys (risk of oral galvanism – electric current between two metals) [USEMAP] Adobe Systems Inlays made of the metal alloy Contraindications oHigh risk of dental caries o oSmall and shalow cavities o oNo in frontal area [USEMAP] Adobe Systems Inlay Advantages ØBetter anatomic form Ø ØBetter polished Ø [USEMAP] Adobe Systems Inlay Disadvantages ØThe technology is not easy Ø ØMore time consuming Ø ØExpensive Ø ØTwo appointments [USEMAP] Adobe Systems Basic rules of preparation ØBox Ø Ø No undercuts Ø Light divergence of the walls (facilitating shape). Angle of divergency 6 – 15° [USEMAP] 1tridaschema Box No undercuts Simple box Facilitating shape [USEMAP] Adobe Systems Inlay of metal alloy ̶Direct method (class I. or V.) - rarely ̶ ̶ ̶Indirect method (in most cases) [USEMAP] Adobe Systems Inlay of metal alloy ØDirect method Ø Ø ̶ ̶ Direct modellation in the mouth Special wax – casting wax, (special polymers) Sprue pin Investment Method of the lost wax [USEMAP] Adobe Systems ̶ Class I. All fissures are involved No undercuts – facilitating form Asymetric outlines Depth 1,5 mm [USEMAP] Adobe Systems Sequence of operations Dental office - Preparation - Isolation of the cavity - Modellation of heated casting wax - Sprue pin – the thickest part,reservoir Dental lab - Investment - Casting (method of lost wax) -Finishing Dental office - Cementation ̶ ̶ [USEMAP] Adobe Systems Inlay of metal alloy Indirect method Ø Taking of the impression Model Modellation of the casting wax, (special polymers) Sprue pin Investment Lost wax method ̶ [USEMAP] Inlay inlaysadra inlayschema [USEMAP] Onlay onlaysadra onlayschema [USEMAP] Overlay overlaysadra overlayschema [USEMAP] Adobe Systems Retention of rigid fillings Against axial forces, depends on 1.Geometry of the preparation 2.Qwuality of the luting material (cement) retence01 retence02 [USEMAP] retence2 retence3 Taper Angle of convergency Rau G. 1994 [USEMAP] C:\Dokumenty\mama\dopisypozdravy\1tridaschema.jpg C:\Dokumenty\mama\dopisypozdravy\1tridapodsekriviny.jpg [USEMAP] C:\Dokumenty\mama\kurzyaobr\inlaye1.jpg [USEMAP] C:\Dokumenty\mama\kurzyaobr\onlaye.jpg [USEMAP] C:\Dokumenty\mama\kurzyaobr\inlayreciproke kotveni.jpg [USEMAP] inlayegingivekt 1tridaschema [USEMAP] otiskovani1 otiskovani2 otisk [USEMAP] speedex medium [USEMAP] kavita na modelu lakovanipahylu cementspacer voskmodel [USEMAP] hotoveinlkov1 hotovrinkov2 voskmodel [USEMAP] dosaznalest1 dosaznalest2 gumovani vruce dosazroztep dosaznalest3 [USEMAP] cementstet cementpritlac cementvasel skusdrevo cementdentnit [USEMAP] Adobe Systems Non metallic inlays ̶Composite ̶ ̶Ceramics ̶ Indirect method CAD CAM [USEMAP] Adobe Systems 35 inl4 [USEMAP] vzhledkavity preparzasady sílamateriálu [USEMAP] Adobe Systems Preparation ̶Box ̶No undercuts ̶Facilitating shape – divergence of the walls appr. 6° ̶No bevel ̶Thickness of the material 1,5 – 2 mm [USEMAP] prepar1 prepar2 kavita dlatko Preparation Standard diamond bur Finishing with Fine dimond bur And hand instruments [USEMAP] brousekdetail sadaprep Special diamonds for preparation [USEMAP] Adobe Systems Fabrication in dental lab – depends on the material ̶ ̶ Cad Cam restorations can be made also chair side. 40 [USEMAP] inlayenamel5 inlayenamel6 [USEMAP] inlayenamel8 [USEMAP] inlayenamel11 [USEMAP] Adobe Systems Cementation ØAdhesive materials – composite cements Ø ØChemically or dual curing low viscosity materials Ø Ø Ø ØAdhesive systems that must be compatible with adhesive cements Ø Ø Ø ̶ [USEMAP] vlozeniinldokav sviceni steteckemodstrpreb leptani adheztmeleni aproxnit bonding disazeniapúridrz oplach protazeniniti [USEMAP] Adobe Systems 46 lenka.roubalikova@tiscali.cz maryland v ustech The cement is covered with glycerin gel Inhibition layer is not present glycgel [USEMAP] lenka.roubalikova@tiscali.cz 47 onlay1 IMG_2084 hjkovanamodelu hajkova.JPG [USEMAP] Adobe Systems ̶ panavia [USEMAP] Adobe Systems Selfcuring cements Panavia 21 (Kuraray) Dyract Cem (DENTSPLY De Trey) [USEMAP] Adobe Systems Light curing cements ̶For thin veneers only ̶ [USEMAP] lenka.roubalikova@tiscali.cz 51 P1010032 [USEMAP] Adobe Systems Dual curing cements ̶Two initiating systems P1010032 [USEMAP] lroubal@med.muni.cz 53 P1010033 [USEMAP] lenka.roubalikova@tiscali.cz 54 I:\adhezivní cementy\source\images\Multilink Automix\Multilink Automix_System Pack_web.jpg [USEMAP] Adobe Systems IMG_5114.JPG IMG_5115.JPG IMG_5116.JPG IMG_5117.JPG [USEMAP] lenka.roubalikova@tiscali.cz 56 IMG_5119.JPG IMG_5120.JPG [USEMAP] lenka.roubalikova@tiscali.cz 57 IMG_5121.JPG [USEMAP] Adobe Systems Indirect restoration of anterior teeth ̶Veneers ̶ ̶Crowns ̶ ̶Ceramics ̶Composits (rare) 58 [USEMAP] Adobe Systems Indications ̶Hypoplasia ̶Diastema, spaced frontal teeth ̶Discoloration ̶Multiple filling Definujte zápatí – název prezentace nebo pracoviště 59 [USEMAP] Adobe Systems Contraindications ̶High caries risk ̶Bad oral hygiene ̶Bruxism, deep bite Consider full crown Definujte zápatí – název prezentace nebo pracoviště 60 [USEMAP] Adobe Systems Material ̶Lithidudisilicate ceramics ̶ ̶Made on model or CAD Cam 61 [USEMAP] Adobe Systems Preparation – incisal edge involved Definujte zápatí – název prezentace nebo pracoviště 62 ̶ [USEMAP] Adobe Systems Acid etching Definujte zápatí – název prezentace nebo pracoviště 63 [USEMAP] Adobe Systems Bonding Definujte zápatí – název prezentace nebo pracoviště 64 [USEMAP] Adobe Systems [USEMAP] Adobe Systems Adhesive preparation of veneers and crowns IMG_5114.JPG IMG_5115.JPG IMG_5116.JPG IMG_5117.JPG [USEMAP] Adobe Systems Cementation ̶ 67 IMG_5120.JPG [USEMAP] Adobe Systems ̶ Cementation 68 IMG_5121.JPG [USEMAP] lenka.roubalikova@tiscali.cz 69 IMG_5122.JPG [USEMAP] Adobe Systems Material ̶Lithidudisilicate ceramics ̶ ̶Made on model or CAD Cam 70 [USEMAP]