Técnicas y materiales adecuados usados en la prevención de la microfiltración en las restauraciones dentarias
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2012-07-16
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Universidad de Guayaquil. Facultad Piloto de Odontología
Resumen
El objetivo de la odontología restauradora es devolver la anatomía y funcionalidad de las piezas dentarias que han sido afectadas por caries dental, traumatismos, malformaciones congénitas y/o hereditarias que han dejado como secuela la pérdida de sustancia o el debilitamiento de los tejidos dentarios.
Para resolver estos problemas recurrimos al uso de biomateriales dentales que permitan que las piezas afectadas recuperen su forma y a través de esto su función y estética. Solucionando problemas biológicos, psicológicos y sociales del paciente, preservando así la salud y el equilibrio del ecosistema bucal.
En los últimos tiempos los nuevos biomateriales tienen gran importancia por su composición ya que nos ayudan tanto en el aspecto estético y mecánico de la restauración, estos siempre buscan ser lo más adhesivos posible a las estructuras dentales como también nos aseguran el objetivo que es sellar las preparaciones cavitarías para evitar las micro filtraciones que irían en perjuicio de la salud de la pieza dentaria a tratarse. Estos biomateriales deben de garantizarnos una unión química primaria a los tejidos dentarios de tal manera que al unirse íntimamente al diente se elimine la interface diente/restauración.
Los estudios también demuestran que después de haber avanzado en materiales de última generación como resinas de microrelleno, nanorelleno e hibridas todavía no se encuentra el material ideal para solucionar este problema tan antiguo en las restauraciones.
Entre los biomateriales de restauraciones estéticas que ha logrado resultados óptimos encontramos resinas compuestas, sin embargo algunas o su mayoría no logran una unión química deseada con el tejido dentario, razón por la que se recurre a lograr adhesión de tipo micromecánico que se obtiene a través de técnicas de grabado ácido y el uso de adhesión a esmalte y dentina. Pero estos tipos de materiales por
2
su proceso de contracción que sufren al polimerizar no obtienen una interface cero lo que traduce a un sellado marginal imperfecto que permite la aparición de una brecha con la consiguiente microfiltración marginal, permitiendo un pasaje clínicamente indetectable de fluidos con bacterias, hongos, virus que se encuentran en la flora bacteriana bucal, esto nos puede traer como consecuencia hipersensibilidad dentaria, irritación pulpar, inflamación del periodonto si es cerca del cuello cervical y puede producir caries recurrentes así como también la corrosión, disolución o decoloración de ciertos materiales dentales.
Para que estos fenómenos no sucedan y las resinas se adhieran de manera eficaz y duradera a la estructura dentaria debemos de utilizar adhesivos que nos aseguren un sellado más hermético disminuyendo las brechas entre el tejido dentario y la restauración.
Actualmente se utilizan sistemas mediante la aplicación de la técnica de grabado acido total que graban esmalte y dentina esta técnica nos permite eliminar el barrillo dentinario, abrir los túbulos dentinarios, aumentar la permeabilidad dentaria, desmineralizar la dentina peri e intertubular dejando una matriz de colágeno expuesta que debe mantenerse húmeda. Después del acondicionamiento del tejido con ácido grabador, se aplican el sistema adhesivo en una o más capas según el tipo de agente adhesivo y de acuerdo a las instrucciones del fabricante.
The goal of restorative dentistry is to restore the anatomy and function of the teeth that have been affected by dental caries, trauma, congenital malformations and / or who have left hereditary aftermath substance loss or weakening of the dental tissues . To solve these problems we resort to the use of dental biomaterials that enable the affected parts regain their form and through this function and aesthetics. Solving biological, psychological and social problems of the patient, thus preserving the health and balance of the oral ecosystem. In recent times new biomaterials have great importance for its composition and that help us both aesthetic and mechanical aspect of restoration, these are always looking to be as adhesives to dental structures may also assure us that the goal is to seal the cavity preparations to avoid micro leaks that would adversely affect the health of the tooth treated. These biomaterials should warrant that a primary chemical bonding to tooth tissue so as to intimately join the interface tooth / tooth restoration is removed. Studies also show that having advanced art materials microfilled resins , and hybrid nanofiller still not ideal to solve this problem as old restorations material is . Among the biomaterials restorations that has achieved excellent results found composites , however some or most do not achieve desired chemical bond with tooth structure , reason is used to obtain adhesion of micromechanical type obtained through etching techniques and the use of adhesion to enamel and dentin. But these types of materials by 2 its process when curing shrinkage sufferers do not obtain zero interface which translates to an imperfect marginal seal allowing the occurrence of a gap with the consequent microleakage , clinically undetectable allowing passage of fluids with bacteria, fungi , viruses found in the oral bacterial flora , it can bring us resulting dental hypersensitivity , pulp irritation , inflammation of the periodontium if near the cervix and can cause secondary caries as well as corrosion , dissolution or bleaching of certain dental materials. For these phenomena happen and resins adhere effective and lasting way to tooth structure must use adhesives that will ensure a tight seal reducing the gaps between the tooth structure and restoration. Systems currently used by applying the technique of acid engraving total etch enamel and dentin this technique allows us to remove the smear layer , open dentinal tubules , increase dental permeability, demineralized dentin and intertubular peri leaving a collagen matrix exposed which must be kept moist. After the fabric conditioning etchant , the adhesive system is applied in one or more layers depending on the type of adhesive agent and according to the manufacturer's instructions.
The goal of restorative dentistry is to restore the anatomy and function of the teeth that have been affected by dental caries, trauma, congenital malformations and / or who have left hereditary aftermath substance loss or weakening of the dental tissues . To solve these problems we resort to the use of dental biomaterials that enable the affected parts regain their form and through this function and aesthetics. Solving biological, psychological and social problems of the patient, thus preserving the health and balance of the oral ecosystem. In recent times new biomaterials have great importance for its composition and that help us both aesthetic and mechanical aspect of restoration, these are always looking to be as adhesives to dental structures may also assure us that the goal is to seal the cavity preparations to avoid micro leaks that would adversely affect the health of the tooth treated. These biomaterials should warrant that a primary chemical bonding to tooth tissue so as to intimately join the interface tooth / tooth restoration is removed. Studies also show that having advanced art materials microfilled resins , and hybrid nanofiller still not ideal to solve this problem as old restorations material is . Among the biomaterials restorations that has achieved excellent results found composites , however some or most do not achieve desired chemical bond with tooth structure , reason is used to obtain adhesion of micromechanical type obtained through etching techniques and the use of adhesion to enamel and dentin. But these types of materials by 2 its process when curing shrinkage sufferers do not obtain zero interface which translates to an imperfect marginal seal allowing the occurrence of a gap with the consequent microleakage , clinically undetectable allowing passage of fluids with bacteria, fungi , viruses found in the oral bacterial flora , it can bring us resulting dental hypersensitivity , pulp irritation , inflammation of the periodontium if near the cervix and can cause secondary caries as well as corrosion , dissolution or bleaching of certain dental materials. For these phenomena happen and resins adhere effective and lasting way to tooth structure must use adhesives that will ensure a tight seal reducing the gaps between the tooth structure and restoration. Systems currently used by applying the technique of acid engraving total etch enamel and dentin this technique allows us to remove the smear layer , open dentinal tubules , increase dental permeability, demineralized dentin and intertubular peri leaving a collagen matrix exposed which must be kept moist. After the fabric conditioning etchant , the adhesive system is applied in one or more layers depending on the type of adhesive agent and according to the manufacturer's instructions.
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ODONTOLOGIA RESTAURADORA, ODONTOLOGIA PREVENTIVA, CARIES DENTALES, MATERIALES DENTALES