nyeste viden inden for plast

Transkript

1 nyeste viden inden for plast DOFT Årsmøde 2014 Nyborg Strand d. 26. september 2014 tandlæge Jan Frydensberg Thomsen Colosseumklinikken København og KU

2 bonding forskellige systemer 1. 3 trin (ætse - prime - bonde) 2. 2 trin (ætse - prime/bonde) etch and rinse systems 3. 2 trin (ætse/prime - bonde) 4. 1 trin (ætse/prime/bonde) self etch systems

3 Relationship between bond strength tests and clinical outcomes Van Meerbeek B, Peumans M, Poitevin A, Mine A, Van Ende A, De Munck J Leuven BIOMAT Research Cluster, Department of Conservative Dentistry, School of Dentistry, Oral Pathology and Maxillo-Facial Surgery, Catholic University of Leuven, Kapucijnenvoer 7, B-3000 Leuven, Belgium.

4 A field emission SEM study of dentin etched with different phosphoric acid compositions and/or concentrations Jorge Perdigao, Paul Lambrechts, Bart Van Meerbeek, Guido Vanherle Department of Operative Dentistry and Dental Materials Katholieke Universiteit te Leuven Belgium 1994 session of the InternationalAssociation for Dental Reseach Continental European Division

5 konklusion demineraliseringsdybden i dentin synes ikke relateret til koncentrationen af syren andre faktorer spiller en rolle : bæremediet farvestoffet overfladespændings reducerende stoffer

6 Jans konklusion adhæsiver emaljebinding : etch & rinse self etch 6

7 Jans konklusion adhæsiver dentinbinding : etch & rinse : micromekanisk! self etch : kemisk! 7

8 konklusion adhæsiver Jans forslag : etch & rinse self etch selektiv ætsning af emalje og self etch primer og bond 2 flaske self etch system 8

9 skal man bruge kofferdam? 9

10 Raskin A, Setcos JC, Vreven J, Wilson NH (2000). Influence of the isolation method on the 10-year clinical behaviour of posterior resin composite restorations. Clin Oral Investig 4(3): No influence of rubber dam on survival rate compared to cotton roll isolation

11 hvad med lyset? hvad er vigtigt at vide om polymeriseringslamper?

12 1.0 QTH ABSORBANCE st & 2nd GEN LED 3rd GEN LED Prof. Rueggeberg WAVELENGTH (nm)

13 mest effektive og universelle pol. lamper har kombination af led-chips med forskellige bølgelængder 465 nm 405 nm 445 nm 465 nm

14 Over 37% of composite restorations are insufficiently cured! JADA (Fan et al, 2002).

15 op til 50 % af output mistes ved en vinkel på 45 polymeriseringstiden skal fordobles

16 polymeriseringslamper kan producereforholdsvis meget varme på rødt eller blødt væv. men varmeudviklingen er ikke noget problem på en tands hvide overflade. rød vs hvid test : rødt og hvidt tape!

17 Indica'on No difference in survival probability Survival rate at 57 months: 94% for ceramic inlays 93% for composite restora'ons Lange and Pfeiffer (2009). Oper Dent 34(3):

18 Indica'on No failures amer 30 months for cusp replacements in molars (1-2 cusps replaced) Only alpha ra'ngs Deliperi and Bardwell (2006). J Esthet Restor Dent 18(5):

19 Indica'on Case reports, personal experience, but hardly any clinical studies Esr'mated overall survial rate of direct composite crowns on endodon'cally treated teeth : 53% at 17 years. Fokkinga et al. (2008). Int J Dent Prothoddont 21(2):

20 bulkfill Tetric EvoCeram Bulk Fill / Ivoclar Vivadent SDR Flow / Dentsply SonicFill / Kerr 20

21 21

22 wedjets

23 contourstrip 23

24 alternativ brug af composite 24

25 Ekstraoral-chairside metode

26 26

27 1. kontrol efter 2 mdr 27