Análisis comparativo de la adhesividad entre ionómero de vidrio convencional y los ionómeros de vidrio resinomodificados
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2013-06-21
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Universidad de Guayaquil. Facultad Piloto de Odontología
Resumen
Dentro de la odontología, la operatoria dental es una especialidad que se practica con mayor frecuencia, y en especial las restauraciones de resina es el procedimiento que más realizamos en nuestros consultorios, puesto que en la actualidad los pacientes no gustan de las restauraciones con amalgama. Sin embargo los procedimientos de obturación con resina, son los que generan mayores problemas postoperatorios tales como: pigmentación de los márgenes, sensibilidad a los cambios térmicos, dolor, dificultad al masticar, llegando en muchos de los casos a terminar en un tratamiento endodontico. Es por eso que el odontólogo al restaurar lesiones cariosas se encuentra frente a distintos retos que debe solventar poniendo en práctica los conocimientos, respetando la importancia de usar materiales que sean biocompatibles con los tejidos y usar las técnicas que conserven la mayor cantidad de tejidos sobre los cuales se trabaja.
El presente trabajo nos presenta una análisis comparativo entre ionomeros convencionales y los resinomodificados, que nos permita determinar la fuerza de adhesión que dispone cada uno de los ionomeros de vidrio ya sean convencionales o resinomodificados e identificar su uso e importancia. Pretendemos identificar todos los factores que favorecen la adhesividad de los ionomeros de vidrio, determinar las propiedades que poseen los ionomeros vítreos, conocer cuál es el mecanismo de acción de los diferentes ionomeros de vidrio y determinar la importancia que tiene el grabado previo del sustrato dentario, sobre el cual se va a trabajar.
Cuando los estudios revelaron la formación de la capa hibrida y sus detallen en la dentina, surgieron evidencias de que la zona de dentina desmineralizada no resultaba penetrada totalmente por los agentes adhesivos, y esto permitía que las fibrillas de colágeno que fueron expuestas al realizarse la desmineralización, resulten desprotegidas ante la acción de los fluidos orales. Esta demostración donde el área de dentina no infiltrada por los adhesivos era porosa y permeable a los
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fluidos externos, se conoció como “nanofiltracion”. Posterior a este estudio se formuló la hipótesis de que la perdida de resistencia adhesiva observada a largo plazo se debía a la degradación de las fibrillas de colágeno que se encuentran expuestas y desprotegidas..
Se utilizan como material temporal de obturación después de una endodoncia, como protectores: liners, bases y forros cavitarios, también son usados en los procedimientos para la inactivación de estas caries, porque son excelentes remineralizadores (manchas blancas), o cuellos expuestos que son los causantes de la presencia de la sintomatología dolorosa, se usan para cementado en prótesis fija, ortodoncia, incrustaciones.
Los ionomeros vítreos convencionales se endurecen mediante una reacción de ácido base, el fraguado es por lo tanto solo químico, no se activan con luz y los resinomodificados complementan su acción de fraguado acido–base con una reacción de fotopolimerización.
Dentro de las propiedades de los ionomeros vítreos se encuentran adhesividad, biocompatibilidad, liberación de fluor, estabilidad dimensional, propiedades mecánicas.
Si bien el agua desempeña un papel muy importante para obtener adhesión también deteriora el adhesivo y degrada el colágeno a largo tiempo, puede establecer cuadros que determinen los mecanismos de degradación de la interface adhesiva, puede también dificultar la infiltración de los monómeros y comprometer su polimerización al momento de la hibridización.
Según lo analizado en este trabajo los ionomeros de vidrio convencionales nos proporcionan mayor adhesividad que los resinomoificados, sin embargo requieren mayor tiempo de tratamiento, su costo es bajo, su estética baja, pero alta efectividad, los ionomeros vítreos resino modificados requieren menor tiempo de trabajo, ofrecen mayor estética, son de costo más alto y ofrecen menor efectividad.
Within dentistry, operative dentistry is a specialty that is practiced more frequently , especially composite restorations is the procedure most performed in our offices , as currently patients dislike amalgam restorations . However, the resin filling procedures are those that generate higher postoperative problems such as pigmentation margins , sensitivity to temperature changes , pain, difficulty chewing , reaching in many cases end up in a endodontics treatment . That's why the dentist to restore carious lesions were found in response to various challenges to be overcome by implementing the knowledge, respecting the importance of using materials that are biocompatible with the tissues and use the techniques that preserve as much tissue on which works . This paper presents a comparative analysis between conventional ionomers and resinomodificados , allowing us to determine the adhesion strength available each glass ionomer whether conventional or resinomodificados and identify its use and importance. We intend to identify all factors that promote adhesion of glass ionomer , determine the properties of glass- ionomer have , know what the mechanism of action of different glass ionomer and determine the importance of prior etching of the dental substrate , on which it will work . When studies revealed the formation of the hybrid layer and detailed in the dentin , there was evidence that the area of demineralized dentin was not entirely penetrated by the adhesive agent , and this allowed the collagen fibrils that were exposed to the demineralization performed , resulting unprotected before the action of oral fluids. This demonstration where the area infiltrated dentin adhesives was porous and permeable . 2 external fluids , was known as " nanofiltration " . Following this study, the hypothesis that the loss of adhesive strength was observed in the long term due to the degradation of the collagen fibrils that are exposed and unprotected formulated .. Are used as a temporary filling material after endodontic treatment such as : Protective liners , bases and cavitary liners are also used in methods for the inactivation of these cavities, because they are excellent remineralizing (white spots ) , or necks exposed which are cause of the presence of pain symptoms , are used for cemented fixed prosthesis , orthodontics , inlays . Conventional glass ionomer cements are cured by acid-base reaction , thereby curing only is chemical by not activated by light and complementing their action resinomodificados acid-base setting a photopolymerization reaction . Within the glass ionomer properties are adhesiveness , biocompatibility , fluoride release , dimensional stability , mechanical properties. Although water plays a very important for adhesion paper also impairs the adhesive and degrades collagen long time , you can set tables to determine the mechanisms of degradation of the adhesive interface , it can also hinder the infiltration of monomers and compromise its polymerization upon hybridization . As discussed in this paper the conventional glass ionomer provide us greater adhesiveness than resinomoificados however require longer treatment , the cost is low , low aesthetic , but highly effective , modified glass- ionomer resino require less time working offer greater aesthetics are higher cost and offer less effective.
Within dentistry, operative dentistry is a specialty that is practiced more frequently , especially composite restorations is the procedure most performed in our offices , as currently patients dislike amalgam restorations . However, the resin filling procedures are those that generate higher postoperative problems such as pigmentation margins , sensitivity to temperature changes , pain, difficulty chewing , reaching in many cases end up in a endodontics treatment . That's why the dentist to restore carious lesions were found in response to various challenges to be overcome by implementing the knowledge, respecting the importance of using materials that are biocompatible with the tissues and use the techniques that preserve as much tissue on which works . This paper presents a comparative analysis between conventional ionomers and resinomodificados , allowing us to determine the adhesion strength available each glass ionomer whether conventional or resinomodificados and identify its use and importance. We intend to identify all factors that promote adhesion of glass ionomer , determine the properties of glass- ionomer have , know what the mechanism of action of different glass ionomer and determine the importance of prior etching of the dental substrate , on which it will work . When studies revealed the formation of the hybrid layer and detailed in the dentin , there was evidence that the area of demineralized dentin was not entirely penetrated by the adhesive agent , and this allowed the collagen fibrils that were exposed to the demineralization performed , resulting unprotected before the action of oral fluids. This demonstration where the area infiltrated dentin adhesives was porous and permeable . 2 external fluids , was known as " nanofiltration " . Following this study, the hypothesis that the loss of adhesive strength was observed in the long term due to the degradation of the collagen fibrils that are exposed and unprotected formulated .. Are used as a temporary filling material after endodontic treatment such as : Protective liners , bases and cavitary liners are also used in methods for the inactivation of these cavities, because they are excellent remineralizing (white spots ) , or necks exposed which are cause of the presence of pain symptoms , are used for cemented fixed prosthesis , orthodontics , inlays . Conventional glass ionomer cements are cured by acid-base reaction , thereby curing only is chemical by not activated by light and complementing their action resinomodificados acid-base setting a photopolymerization reaction . Within the glass ionomer properties are adhesiveness , biocompatibility , fluoride release , dimensional stability , mechanical properties. Although water plays a very important for adhesion paper also impairs the adhesive and degrades collagen long time , you can set tables to determine the mechanisms of degradation of the adhesive interface , it can also hinder the infiltration of monomers and compromise its polymerization upon hybridization . As discussed in this paper the conventional glass ionomer provide us greater adhesiveness than resinomoificados however require longer treatment , the cost is low , low aesthetic , but highly effective , modified glass- ionomer resino require less time working offer greater aesthetics are higher cost and offer less effective.
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OPERATORIA DENTAL