Restauración adhesiva de segunda clase con la utilización de porta matriz
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2011-04-15
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Universidad de Guayaquil. Facultad de Odontología
Resumen
El presente trabajo, busca plasmar los principios básicos de la preparación
cavitaria; donde el éxito de la restauración dental dependerá del retiro de
las estructuras infectadas y de una óptima integración de los biomateriales
dentales restauradores de los tejidos dentarios.
La restauración sin caries imperceptibles, en sector posterior, es una
demanda cada vez más frecuente por parte de los pacientes. El desarrollo
de técnicas y materiales que tornan estas restauraciones más fáciles y
fiables, ha contribuido a que se produzca un aumento exponencial de la
utilización clínica de las resinas compuestas en la restauración de dientes
posteriores.
No obstante, se sabe que existen algunos problemas clínicos en las
restauraciones de cavidades clase II, que podrían derivar del uso de las
resinas compuestas híbridas convencionales. Por ejemplo, puede ocurrir
una falla del material en la interfase de la pared gingival, debido a la
incapacidad técnica de conseguir adaptar los materiales, de forma
adecuada, a los márgenes antes de polimerizar. De esto, pueden resultar
sensibilidad post-operatoria y caries recidivantes. También es común la
dificultad en la obtención de puntos de contacto que resultan de la
sensibilidad a la técnica de este material durante su manipulación.
Para facilitar su manipulación , los investigadores opinan que la resina
compuesta ideal, debería tener una viscosidad suficientemente rígida que
evitase que se adhiera al instrumento condensador. La introducción en el
mercado de los composites “condensables” o “compactables”, constituyó
una evolución que permitió a los dentistas dar un paso más. Se comprobó
entonces que el manejo de estos composites era mucho más interesante,
pero que su adaptación marginal y la resistencia al desgaste no eran los
ideales.
Una vez que se entiende que el manejo de los composites compactables
es más fácil que el de otros composites, facilitando la realización de
restauraciones de Clase II y acortando el tiempo de consulta, procuramos
desarrollar una técnica que permitiese compensar los problemas que este
material presenta.
Los autores presentan una Técnica Incremental Modificada, que tiene
como principales objetivos: la preservación de las cualidades de los
composites compactables , facilitar la inserción y adaptación de los
composites en las cajas proximales profundas y estrechas, mejorar la
adaptación marginal a nivel del borde gingival de la caja proximal, mejorar
la adaptación y resistencia marginal en los bordes laterales de la caja
oclusal, mejorar la resistencia al desgaste de estas restauraciones y
facilitar la obtención de un punto de contacto.
Manteniendo los criterios de la Técnica Incremental, esta técnica consiste
en la aplicación de una fina capa de composite híbrido micro-particulado o
nanoparticulado (por ejemplo Spectrum® o Ceram X®) en el fondo de la
preparación cavitaria de clase II o clase I. A continuación, sin polimerizar,
se coloca sobre ésta una capa de compositecompactable (Surefil®). La
capa final de la restauración será realizada con un composite híbrido
microparticulado o nanoparticulado.
Con la interposición de un composite híbrido microparticulado o
nanoparticulado, teniendo estos partículas de menores dimensiones que
los compositescompactables, se pretende una mejor adaptación de la
restauración a la estructura dentaria y una mayor resistencia al desgaste
en la superficie oclusal de la restauración.
This paper seeks to translate the basic principles of preparation cavity , where the success of the dental restoration depends on the removal of infected structures and optimal integration of biomaterials of dental restorative dental tissues . The restoration without noticeable decay, posterior , is a increasingly frequent demand by patients. development techniques and materials that make this easier and restorations reliable , has contributed to an exponential increase occurs Clinical use composite resins for restoration of teeth later . However, it is known that there are some problems in the clinical Class II restorations of cavities that could result from use of the Conventional hybrid composites . For example , it may be a failure of the material at the interface of the gingival wall , due to the inability to achieve technique adapt materials so adequate margins before curing . From this, they can be postoperative sensitivity and recurrent caries. It is also common difficulty in obtaining contact points resulting from sensitivity technique in handling this material . To facilitate handling , the researchers believe that the resin composite ideal, should have a viscosity sufficiently rigid avoided acceding to the condenser instrument. The introduction in the market " condensable " or " compactable " composites formed an evolution that allowed dentists to take another step . It was found then that the management of these composites was much more interesting , but their marginal adaptation and wear resistance were not ideal . Once it is understood that the handling of the composites compactable is easier than other composites , facilitating the realization of Class II restorations and shortening the time of inquiry , we seek develop a technique that allowed offset the problems that this material exhibits . The authors present a Modified Incremental Technique , which has main objectives : the preservation of the qualities of the composites compactable , easy insertion and adaptation composites in deep and narrow proximal boxes , improving marginal adaptation at the gingival margin of the proximal box , improve marginal adaptation and resistance at the lateral edges of the box occlusion , improving the wear resistance of these restorations and facilitate obtaining a contact point . Maintaining the criteria of the increment technique , this technique is in the application of a thin layer of composite or hybrid microparticulate nanoparticulate ( Spectrum ® X ® or Ceram example ) at the bottom of the cavity preparation of class II or class I Next, uncured , it is placed on a layer of compositecompactable ( SureFil ® ) . the final layer of the restoration will be carried out with a hybrid composite microparticle or nanoparticle . With the filing of a microparticle composite or hybrid nanoparticle , having these smaller particles that the compositescompactables , better adaptation of the intended restoration to tooth structure and a higher wear resistance on the occlusal surface of the restoration .
This paper seeks to translate the basic principles of preparation cavity , where the success of the dental restoration depends on the removal of infected structures and optimal integration of biomaterials of dental restorative dental tissues . The restoration without noticeable decay, posterior , is a increasingly frequent demand by patients. development techniques and materials that make this easier and restorations reliable , has contributed to an exponential increase occurs Clinical use composite resins for restoration of teeth later . However, it is known that there are some problems in the clinical Class II restorations of cavities that could result from use of the Conventional hybrid composites . For example , it may be a failure of the material at the interface of the gingival wall , due to the inability to achieve technique adapt materials so adequate margins before curing . From this, they can be postoperative sensitivity and recurrent caries. It is also common difficulty in obtaining contact points resulting from sensitivity technique in handling this material . To facilitate handling , the researchers believe that the resin composite ideal, should have a viscosity sufficiently rigid avoided acceding to the condenser instrument. The introduction in the market " condensable " or " compactable " composites formed an evolution that allowed dentists to take another step . It was found then that the management of these composites was much more interesting , but their marginal adaptation and wear resistance were not ideal . Once it is understood that the handling of the composites compactable is easier than other composites , facilitating the realization of Class II restorations and shortening the time of inquiry , we seek develop a technique that allowed offset the problems that this material exhibits . The authors present a Modified Incremental Technique , which has main objectives : the preservation of the qualities of the composites compactable , easy insertion and adaptation composites in deep and narrow proximal boxes , improving marginal adaptation at the gingival margin of the proximal box , improve marginal adaptation and resistance at the lateral edges of the box occlusion , improving the wear resistance of these restorations and facilitate obtaining a contact point . Maintaining the criteria of the increment technique , this technique is in the application of a thin layer of composite or hybrid microparticulate nanoparticulate ( Spectrum ® X ® or Ceram example ) at the bottom of the cavity preparation of class II or class I Next, uncured , it is placed on a layer of compositecompactable ( SureFil ® ) . the final layer of the restoration will be carried out with a hybrid composite microparticle or nanoparticle . With the filing of a microparticle composite or hybrid nanoparticle , having these smaller particles that the compositescompactables , better adaptation of the intended restoration to tooth structure and a higher wear resistance on the occlusal surface of the restoration .
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Palabras clave
OPERATORIA DENTAL, RESTAURACION DENTAL, CARIES DENTALES, ADHESION DENTAL