Fracasos en restauraciones adhesivas directas
Fecha
2012-06-15
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Universidad de Guayaquil. Facultad Piloto de Odontología
Resumen
A pesar del progreso de los materiales junto con los sistemas adhesivos,
protectores pulpares, resinas compuestas, no se han podido lograr la
restauración ideal, y el problema de la filtración marginal continua el cual
dará los fracasos de las restauraciones.
Para que la restauración sea exitosa la obturación debe perdurar en
contacto íntimo con la estructura dentaria ya que si existe integración
entre ambos, el diente restaurado funcionara con un comportamiento
mecánico similar al del diente sano.
Los métodos y materiales ideales para evitar los fracasos en
restauraciones adhesivas directas serian: realizar un buen diagnóstico,
realizar un buen aislamiento, realizar la técnica más adecuada con
respecto al caso, elegir también un buen material o instrumental utilizar.
Entonces los materiales de restauración ideales serian aquellos que no
sufrirían contracciones volumétricas durante las reacciones de
polimerización pero está demostrado que las resina se contraen durante
dicho proceso, el principal inconveniente es que la contracción de
polimerización se dirige hacia la superficie externa del material expuesto a
la luz (fotoactivados) se debe a que esa parte polimeriza primero, el
endurecimiento y contracción de los composites generan fuerzas que los
separa de la superficie dentaria, permitiendo en el futuro la consecuente
filtración marginal, este defecto marginal originara problemas tales como
el aumento de sensibilidad, cambios de coloración, penetración de
microorganismos que pueden ocasionar problemas pulpares. Por otra
parte, aumentara el riesgo de caries secundaria; esto se considera uno de
los mayores fracasos en operatoria dental.
La adhesión logra obtener una buena integración y continuidad entre las
estructuras dentarias y el material, es imprescindible para alcanzar el
sellado marginal. Sin este no existe, penetraran en el diente los
2
componentes del medio bucal microorganismo, sustancias de la saliva
etc.
Muchas veces no se puede observar a simple vista o con instrumental la
existencia de defectos en el sellado marginal y clínicamente la
restauración aparenta haber quedado bien, a largo plazo, la filtración
marginal hará fracasar la obturación con la colonización entre el material
restaurador y el diente.
Despite the progress of the materials along with adhesive systems , pulp protectors, composite resins have not been able to achieve perfect restoration, and the problem of continuous filtration which marginal give the failures of restorations . To be successful restoration sealing must last intimate contact with the tooth structure because if there is integration between them, the restored tooth function with behavior mechanically similar to the healthy tooth . The methods and ideal materials to avoid failures would direct adhesive restorations : a good diagnosis , make good insulation, make the most appropriate technique on the case, also choose a good material or instrumental use . Then restore ideal materials would be those not volumetric contractions suffer reactions polymerization but is shown to shrink during resin this process , the main drawback is that the contraction of Polymerization is directed toward the outer surface of the material exposed to light ( photoactivated ) is because that part polymerized first, hardening and contraction forces generated composites that separates from the tooth surface , allowing consequent future marginal leakage , this marginal defect originated problems such as increased sensitivity , discoloration , penetrating microorganisms that can cause problems pulp . Alternatively hand, increase the risk of secondary caries , this is considered one of the greatest failures in operative dentistry . Adherence manages to get a good integration and continuity between dental materials and structures , it is essential to achieve the marginal sealing . Without this there , penetrate the tooth 2 components of the oral microorganism , substances from saliva etc . Many times you can not see with the naked eye or with the instrumental existence of defects in the marginal seal and clinically restoration appears to have been well in the long run , the filtration marginal seal will fail with colonization between material restorative and tooth.
Despite the progress of the materials along with adhesive systems , pulp protectors, composite resins have not been able to achieve perfect restoration, and the problem of continuous filtration which marginal give the failures of restorations . To be successful restoration sealing must last intimate contact with the tooth structure because if there is integration between them, the restored tooth function with behavior mechanically similar to the healthy tooth . The methods and ideal materials to avoid failures would direct adhesive restorations : a good diagnosis , make good insulation, make the most appropriate technique on the case, also choose a good material or instrumental use . Then restore ideal materials would be those not volumetric contractions suffer reactions polymerization but is shown to shrink during resin this process , the main drawback is that the contraction of Polymerization is directed toward the outer surface of the material exposed to light ( photoactivated ) is because that part polymerized first, hardening and contraction forces generated composites that separates from the tooth surface , allowing consequent future marginal leakage , this marginal defect originated problems such as increased sensitivity , discoloration , penetrating microorganisms that can cause problems pulp . Alternatively hand, increase the risk of secondary caries , this is considered one of the greatest failures in operative dentistry . Adherence manages to get a good integration and continuity between dental materials and structures , it is essential to achieve the marginal sealing . Without this there , penetrate the tooth 2 components of the oral microorganism , substances from saliva etc . Many times you can not see with the naked eye or with the instrumental existence of defects in the marginal seal and clinically restoration appears to have been well in the long run , the filtration marginal seal will fail with colonization between material restorative and tooth.
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Palabras clave
RESTAURACION DENTAL, MATERIALES DENTALES, ADHESION DENTAL