class iv direct composite
Transcript of class iv direct composite
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CLASS III, IV and V DIRECT COMPOSITE
RESTORATIONS Upload By : Ahmed Ali Abbas
Babylon University College of Dentistry
download this file from Website on google theoptimalsmile.wix.com/dentistry
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Indications:
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Indications:
restorations in esthetic prominent areas
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Indications:
restorations in esthetic prominent areas
areas can be adequately isolated
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Indications:
restorations in esthetic prominent areas
areas can be adequately isolated tooth preparations that have an all
enamel margins
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Contraindications:
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Contraindications:
an operating area that cannot be adequately isolated
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Contraindications:
an operating area that cannot be adequately isolated
class v restorations that are not esthetically critical
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Contraindications:
an operating area that cannot be adequately isolated
class v restorations that are not esthetically critical
restorations that extends into the root surface (contraction gap)
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Advantages
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Advantages
esthetics
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Advantages
esthetics conservative of tooth structure
removal
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Advantages
esthetics conservative of tooth structure
removal less complex when preparing the
tooth
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Advantages
esthetics conservative of tooth structure
removal less complex when preparing the
tooth low thermal conductivity (insulative)
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Advantages
esthetics conservative of tooth structure
removal less complex when preparing the
tooth low thermal conductivity (insulative) Used almost universally
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Advantages (continued)
bonded to tooth structure
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Advantages (continued)
bonded to tooth structure Repairable
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Disadvantages
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Disadvantages
may result to gap formation
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Disadvantages
may result to gap formation restoration is more difficult, time-
consuming, costly
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Disadvantages
may result to gap formation restoration is more difficult, time-
consuming, costly more technique sensitive
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Disadvantages
may result to gap formation restoration is more difficult, time-
consuming, costly more technique sensitive may exhibit more wear in areas of
high occlusion
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Disadvantages
may result to gap formation restoration is more difficult, time-
consuming, costly more technique sensitive may exhibit more wear in areas of
high occlusion have a higher linear coefficient of
thermal expansion
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COMPOSITE
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COMPOSITE introduced commercially in 1962 by
Bowen of the National Bureau of Standards
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COMPOSITE introduced commercially in 1962 by
Bowen of the National Bureau of Standards
most popular tooth colored material
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COMPOSITE introduced commercially in 1962 by
Bowen of the National Bureau of Standards
most popular tooth colored material consist of a continuous polymeric or
resin matrix in which an inorganic filler is dispersed
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Classification
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Classification
1. Conventional
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Classification
1. Conventional2. Microfilled
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Classification
1. Conventional2. Microfilled3. Hybrid
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Classification
1. Conventional2. Microfilled3. Hybrid
.1 Flowable
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Classification
1. Conventional2. Microfilled3. Hybrid
.1 Flowable
.2 Packable
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Classification
1. Conventional2. Microfilled3. Hybrid
.1 Flowable
.2 Packable4. Nanofilled
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Composition
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Composition
1. Organic Resin
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Composition
1. Organic Resin – forms the matrix
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Composition
1. Organic Resin – forms the matrix-dimethacrylate monomer (BIS-GMA)
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Composition
1. Organic Resin – forms the matrix-dimethacrylate monomer (BIS-GMA)2. Inorganic filler
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Composition
1. Organic Resin – forms the matrix-dimethacrylate monomer (BIS-GMA)2. Inorganic filler- inhibits deformation of the matrix
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Composition
1. Organic Resin – forms the matrix-dimethacrylate monomer (BIS-GMA)2. Inorganic filler- inhibits deformation of the matrix-reduce the coefficient of thermal
expansion of the resin matrix
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Composition
A. Organic Resin – forms the matrix-dimethacrylate monomer (BIS-GMA)B. Inorganic filler- inhibits deformation of the matrix-reduce the coefficient of thermal
expansion of the resin matrixe.g. fused silica, crystalline quartz,
lithium aluminum silicate, borosilicate glass
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C. Coupling Agent
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C. Coupling Agent – unite the resin with the filler
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C. Coupling Agent – unite the resin with the filler-stress absorber of the filler and
resin
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3. Coupling Agent – unite the resin with the filler-stress absorber of the filler and
resin4. Initiator System
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3. Coupling Agent – unite the resin with the filler-stress absorber of the filler and
resin4. Initiator System – activate the
setting mechanism
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3. Coupling Agent – unite the resin with the filler-stress absorber of the filler and
resin4. Initiator System – activate the
setting mechanism5. Stabilizers
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C. Coupling Agent – unite the resin with the filler-stress absorber of the filler and
resinD. Initiator System – activate the
setting mechanismE. StabilizersF. Pigments
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Conventional Composites
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Conventional Composites
contains 75-80% inorganic filler by weight
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Conventional Composites
contains 75-80% inorganic filler by weight
average particle size 8µml
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Conventional Composites
contains 75-80% inorganic filler by weight
average particle size 8µm large size particle and extremely hard filler
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Conventional Composites
contains 75-80% inorganic filler by weight
average particle size 8µm large size particle and extremely hard filler
rough surface structurestrontium and barium glass (radiopaque)
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Microfilled Composites
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Microfilled Composites
introduced in the late 1970
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Microfilled Composites
introduced in the late 1970 polishable
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Microfilled Composites
introduced in the late 1970 polishable smooth lustrous surface similar to
tooth enamel
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Microfilled Composites
introduced in the late 1970 polishable smooth lustrous surface similar to
tooth enamel particle size is 0.01 – 0.04µm
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Microfilled Composites
introduced in the late 1970 polishable smooth lustrous surface similar to
tooth enamel particle size is 0.01 – 0.04µm contains 35-60% inorganic filler by weight
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some of physical and mechanical properties are inferior
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some of physical and mechanical properties are inferior
wear resistant
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some of physical and mechanical properties are inferior
wear resistant low modulus of elasticity (allow
restoration to flex)
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some of physical and mechanical properties are inferior
wear resistant low modulus of elasticity (allow
restoration to flex) high resin content results in an
increased coefficient of thermal expansion and lower strength
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Use of Microfilled Composites
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Use of Microfilled Composites
used for low stress restorations
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Use of Microfilled Composites
used for low stress restorations buccal and lingual surfaces of class
III and class V
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Hybrid Composites
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Hybrid Composites
combines the properties of conventional and microfilled
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Hybrid Composites
combines the properties of conventional and microfilled
contains 75-85% inorganic filler by weight
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Hybrid Composites
combines the properties of conventional and microfilled
contains 75-85% inorganic filler by weight
particle size is 0.4 – 1µm
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Hybrid Composites
combines the properties of conventional and microfilled
contains 75-85% inorganic filler by weight
particle size is 0.4 – 1µm physical properties is superior to conventional
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predominant direct esthetic resin
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predominant direct esthetic resin have universal clinical applicability
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Use of Hybrid Composites
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Use of Hybrid Composites
used in moderate stress restorations where strength and wear resistance are more important than surface luster
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Use of Hybrid Composites
used in moderate stress restorations where strength and wear resistance are more important than surface luster
Class I, class II, class IV
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Flowable
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Flowable
flows into cavity due to lower viscosity
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Flowable
flows into cavity due to lower viscosity
have lower filler content
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Flowable
flows into cavity due to lower viscosity
have lower filler content inferior physical properties (lower
wear resistance, lower strength)
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Flowable
flows into cavity due to lower viscosity
have lower filler content inferior physical properties (lower
wear resistance, lower strength) used in small class I, pit and fissure
sealant,marginal repair, liner
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easy to use
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easy to use good wettability
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easy to use good wettability favorable handling properties
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Packable (Condensable)
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Packable (Condensable)
more viscous, “thicker, stiffer feel”
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Packable (Condensable)
more viscous, “thicker, stiffer feel” have filler particle feature that
prevents sliding of the filler particle by one another
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Packable (Condensable)
more viscous, “thicker, stiffer feel” have filler particle feature that
prevents sliding of the filler particle by one another
easier restoration of proximal contact
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Packable (Condensable)
more viscous, “thicker, stiffer feel” have filler particle feature that
prevents sliding of the filler particle by one another
easier restoration of proximal contact
similar to the handling of amalgam
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Nanocomposites
Nanotechnology or, for short, nanotech, refers to a field of applied science whose theme is the control of matter on an atomic or molecular scale.
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Generally nanotechnology deals with structures 100 nanometers or smaller, and involves developing materials or devices within that size.
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Nanocomposites are materials that are created by introducing nanoparticulates (often referred to as filler) into a macroscopic sample material (often referred to as the matrix).
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After adding nanoparticulates to the matrix material, the resulting nanocomposite may exhibit drastically enhanced properties. For example, adding carbon nanotubes tends to drastically add to the electrical and thermal conductivity.
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Other kinds of nanoparticulates may result in enhanced optical properties, dielectric or mechanical properties such as stiffness and strenght.
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CLINICAL TECHNIQUE FOR DIRECT CLASS III,
CLASS IV AND CLASS V
RESTORATIONS
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Class III Tooth Preparation
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Class III Tooth Preparation
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Class III Tooth Preparation there is a choice between facial or
lingual entry into the tooth
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Indications for Lingual Approach
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Indications for Lingual Approach1. to conserve facial enamel for
enhanced esthetics
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Indications for Lingual Approach1. to conserve facial enamel for
enhanced esthetics2. carious lesion is positioned
lingually
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Indications for Lingual Approach1. to conserve facial enamel for
enhanced esthetics2. carious lesion is positioned
lingually3. lesion is accessible from the
lingual
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Indications for Facial Approach
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Indications for Facial Approach1. The carious lesion is positioned
facially
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Indications for Facial Approach1. The carious lesion is positioned
facially2. Teeth is irregularly aligned,
making lingual access undesirable.
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Indications for Facial Approach1. The carious lesion is positioned
facially2. Teeth is irregularly aligned,
making lingual access undesirable.3. Extensive caries extent into the
facial surface.
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Indications for Facial Approach1. The carious lesion is positioned
facially2. Teeth is irregularly aligned,
making lingual access undesirable.3. Extensive caries extent into the
facial surface.4. Faulty restoration that was
originally placed at the facial.
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Conventional Class III
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Conventional Class III
indicated for restorations involving the root surface
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Conventional Class III
indicated for restorations involving the root surface
1. using a No. ½, 1, 2 round bur prepare the outline form on the root surface
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Conventional Class III
indicated for restorations involving the root surface
1. using a No. ½, 1, 2 round bur prepare the outline form on the root surface
2. extend the preparation into sound walls
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Conventional Class III
indicated for restorations involving the root surface
1. using a No. ½, 1, 2 round bur prepare the outline form on the root surface
2. extend the preparation into sound walls
3. extend pulpally 0.75mm in depth
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4. The gingival/cervical and incisal wall is perpendicular to the root surface (box like design)
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4. The gingival/cervical and incisal wall is perpendicular to the root surface (box like design)
5. A continuous groove retention can be prepared 0.25 mm (½ of diameter of bur) into dentin of the gingival and incisal walls with a ¼ round bur.
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6. The groove is placed at the junction of the axial and the external walls.
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6. The groove is placed at the junction of the axial and the external walls.
7. Clean preparation and inspect the final preparation.
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Beveled Conventional Class III
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Beveled Conventional Class III
Indicated for replacing an existing defective restoration in the crown portion of the tooth
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Beveled Conventional Class III
Indicated for replacing an existing defective restoration in the crown portion of the tooth
when restoring a large carious lesion for which the need for increased retention and/or resistance form is anticipated.
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Lingual Access
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Lingual Access1. Use a round bur No. 1/2, 1. 2
depending on the size of the caries to enlarge the opening sufficiently to allow for caries removal.
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Lingual Access1. Use a round bur No. 1/2, 1. 2
depending on the size of the caries to enlarge the opening sufficiently to allow for caries removal.
2. Extend external walls to sound tooth structure using a straight bur
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3. Extend the gingival and incisal walls up to extent of caries or location of old restoration.
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3. Extend the gingival and incisal walls up to extent of caries or location of old restoration.
Unless necessary, DO NOT:
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3. Extend the gingival and incisal walls up to extent of caries or location of old restoration.
Unless necessary, DO NOT: include the proximal contact.
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3. Extend the gingival and incisal walls up to extent of caries or location of old restoration.
Unless necessary, DO NOT: include the proximal contact. extend into the facial surface.
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3. Extend the gingival and incisal walls up to extent of caries or location of old restoration.
Unless necessary, DO NOT: include the proximal contact. extend into the facial surface. extend subgingivally
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4. Create an axial wall depth of 0.2mm into the dentin/DEJ (approximately 0.75 – 1.25mm in depth)
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4. Create an axial wall depth of 0.2mm into the dentin/DEJ (approximately 0.75 – 1.25mm in depth)
5. Axial wall is convex, following the external contour of the tooth.
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4. Create an axial wall depth of 0.2mm into the dentin/DEJ (approximately 0.75 – 1.25mm in depth)
5. Axial wall is convex, following the external contour of the tooth.
6. Remove all remaining infected dentin, using a round bur or small spoon excavator.
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7. Remove friable enamel at the margins.
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7. Remove friable enamel at the margins.
8. If necessary, prepare retention (grooves or coves)
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7. Remove friable enamel at the margins.
8. If necessary, prepare retention (grooves or coves)
prepare it along the gingivoxial line angle, and sometimes at the incisoaxial line angle .25 mm with a ¼ round bur.
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9. Place cavosurface bevel or flare at the enamel except at the gingival margin area.
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9. Place cavosurface bevel or flare at the enamel except at the gingival margin area.
10. Use a flame shape or round bur resulting in a 45 degrees angle to the external tooth surface.
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9. Place cavosurface bevel or flare at the enamel except at the gingival margin area.
10. Use a flame shape or round bur resulting in a 45 degrees angle to the external tooth surface.
11. Bevel width should be 0.25 to 0.5mm.
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12. Clean the preparation of any debris and inspect final preparation.
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Facial Access
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Facial Access same stages and steps are followed
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Facial Access same stages and steps are followed procedure is simplified because of
easy access
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Modified Class III
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Modified Class III most used type of cavity
preparation.
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Modified Class III most used type of cavity
preparation. indicated for small and moderate
lesions or faults.
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Modified Class III most used type of cavity
preparation. indicated for small and moderate
lesions or faults. designed to be as conservative as
possible.
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Modified Class III most used type of cavity
preparation. indicated for small and moderate
lesions or faults. designed to be as conservative as
possible. preparation walls have no specific
shapes or forms other than an external angle of 90 or more degrees
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preparation design appears to be scooped or concave
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preparation design appears to be scooped or concave
1. Use a 1/2, 1, 2 round bur, point of entry is within the incisogingival dimension of the lesion, perpendicular to the enamel surface.
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preparation design appears to be scooped or concave
1. Use a 1/2, 1, 2 round bur, point of entry is within the incisogingival dimension of the lesion, perpendicular to the enamel surface.
2. Remove all remaining caries or defect.
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3. No attempt is made to create a uniform axial wall.
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3. No attempt is made to create a uniform axial wall.
4. Place cavosurface bevel or flare at the enamel except at the gingival margin area.
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3. No attempt is made to create a uniform axial wall.
4. Place cavosurface bevel or flare at the enamel except at the gingival margin area.
5. Use a flame shape or round bur resulting in a 45 degrees angle to the external tooth surface.
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3. No attempt is made to create a uniform axial wall.
4. Place cavosurface bevel or flare at the enamel except at the gingival margin area.
5. Use a flame shape or round bur resulting in a 45 degrees angle to the external tooth surface.
6. Bevel width should be 0.25 to 0.5mm.
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7. Clean the preparation of any debris and inspect final preparation.
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Class IV Tooth Preparation
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Class IV Tooth Preparation
preoperative assessment of occlusion is very important (placement of margin in noncontact areas)
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Class IV Tooth Preparation
preoperative assessment of occlusion is very important (placement of margin in noncontact areas)
shade selection is more difficult
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Class IV Tooth Preparation
preoperative assessment of occlusion is very important (placement of margin in noncontact areas)
shade selection is more difficult preparation is similar to Class III
except that the preparation for class IV is extended to the incisal angles
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Class V Tooth PreparationConventional
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Class V Tooth PreparationConventional
the feature of the preparation include a 90 degree cavosurface angle, uniform depth of the axial line angle, and sometimes, groove retention from.
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Class V Tooth PreparationConventional
the feature of the preparation include a 90 degree cavosurface angle, uniform depth of the axial line angle, and sometimes, groove retention from.
conventional design is indicated only for portion of the lesion extended onto the root surface
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1. Use a tapered fissure (No. 700, 701,or 271) or No.1 or 2 round bur.
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1. Use a tapered fissure (No. 700, 701,or 271) or No.1 or 2 round bur.
2. Make entry at 45 degrees angle to tooth surface, this should result to a 90 degree cavosurface.
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1. Use a tapered fissure (No. 700, 701,or 271) or No.1 or 2 round bur.
2. Make entry at 45 degrees angle to tooth surface, this should result to a 90 degree cavosurface.
3. Axial depth is 0.75 mm
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1. Use a tapered fissure (No. 700, 701,or 271) or No.1 or 2 round bur.
2. Make entry at 45 degrees angle to tooth surface, this should result to a 90 degree cavosurface.
3. Axial depth is 0.75 mm-strength of preparation wall
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1. Use a tapered fissure (No. 700, 701,or 271) or No.1 or 2 round bur.
2. Make entry at 45 degrees angle to tooth surface, this should result to a 90 degree cavosurface.
3. Axial depth is 0.75 mm-strength of preparation wall-strength of composite
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1. Use a tapered fissure (No. 700, 701,or 271) or No.1 or 2 round bur.
2. Make entry at 45 degrees angle to tooth surface, this should result to a 90 degree cavosurface.
3. Axial depth is 0.75 mm-strength of preparation wall-strength of composite-placement of retention groove
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4. Axial should follow contour of the tooth.
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4. Axial should follow contour of the tooth.
5. Extent of outline form is dictated by the carious lesion extent.
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4. Axial should follow contour of the tooth.
5. Extent of outline form is dictated by the carious lesion extent.
6. Remove remaining carious lesion
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4. Axial should follow contour of the tooth.
5. Extent of outline form is dictated by the carious lesion extent.
6. Remove remaining carious lesion7. Prepare retention groove (similar
to Class III preparation)
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4. Axial should follow contour of the tooth.
5. Extent of outline form is dictated by the carious lesion extent.
6. Remove remaining carious lesion7. Prepare retention groove (similar
to Class III preparation)8. Clean preparation
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Beveled Conventional Class V
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Beveled Conventional Class V
Indications
![Page 189: class iv direct composite](https://reader031.fdocuments.us/reader031/viewer/2022020116/55a06ccb1a28abc17f8b45a7/html5/thumbnails/189.jpg)
Beveled Conventional Class V
Indications1. replacement of defective class V
restorations
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Beveled Conventional Class V
Indications1. replacement of defective class V
restorations2. large carious lesion
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Beveled Conventional Class V
Indications1. replacement of defective class V
restorations2. large carious lesion exhibits 90 degrees of cavosurface
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Beveled Conventional Class V
Indications1. replacement of defective class V
restorations2. large carious lesion exhibits 90 degrees of cavosurface axial wall depth is uniform (0.2mm
or 0.5 when retention groove is to placed)
![Page 193: class iv direct composite](https://reader031.fdocuments.us/reader031/viewer/2022020116/55a06ccb1a28abc17f8b45a7/html5/thumbnails/193.jpg)
groove is not indicated when periphery of tooth preparation is located in enamel.
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groove is not indicated when periphery of tooth preparation is located in enamel.
remove all infected dentin
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groove is not indicated when periphery of tooth preparation is located in enamel.
remove all infected dentin clean preparation
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Modified Class V
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Modified Class V
indicated for small and moderate lesion and lesion entirely in the enamel
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Modified Class V
indicated for small and moderate lesion and lesion entirely in the enamel
no effort to prepare a butt-joint
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Modified Class V
indicated for small and moderate lesion and lesion entirely in the enamel
no effort to prepare a butt-joint no retention groove
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Modified Class V
indicated for small and moderate lesion and lesion entirely in the enamel
no effort to prepare a butt-joint no retention groove lesion is scooped out
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Modified Class V
indicated for small and moderate lesion and lesion entirely in the enamel
no effort to prepare a butt-joint no retention groove lesion is scooped out preparation has divergent wall
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Modified Class V
indicated for small and moderate lesion and lesion entirely in the enamel
no effort to prepare a butt-joint no retention groove lesion is scooped out preparation has divergent wall axial wall does not have uniform
depth
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prepare tooth with round or elliptical instrument
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prepare tooth with round or elliptical instrument
preparation is extended no deeper than 0.2 mm
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prepare tooth with round or elliptical instrument
preparation is extended no deeper than 0.2 mm
no effort is made to prepare a 90 degree cavosurface margins.
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prepare tooth with round or elliptical instrument
preparation is extended no deeper than 0.2 mm
no effort is made to prepare a 90 degree cavosurface margins.
infected enamel is removed with a round bur or excavator.
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Class V Tooth Preparation for Abrasion/Erosion
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Class V Tooth Preparation for Abrasion/Erosion Abrasion – often V-shaped is a loss
or wearing away due to mechanical forces.
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Class V Tooth Preparation for Abrasion/Erosion Abrasion – often V-shaped is a loss
or wearing away due to mechanical forces.
Erosion- often a saucer shaped notch as a result of chemical dissolutions
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Abfraction/Idiopathic Erosion- may occur as a result of flexure of cervical area under heavy occlusal stress. This occurs as a notched defect.
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Abfraction/Idiopathic Erosion- may occur as a result of flexure of cervical area under heavy occlusal stress. This occurs as a notched defect.
Modified tooth preparation is used for this types of defects.
![Page 213: class iv direct composite](https://reader031.fdocuments.us/reader031/viewer/2022020116/55a06ccb1a28abc17f8b45a7/html5/thumbnails/213.jpg)
Acid Etching
![Page 214: class iv direct composite](https://reader031.fdocuments.us/reader031/viewer/2022020116/55a06ccb1a28abc17f8b45a7/html5/thumbnails/214.jpg)
Acid Etching
A physical process that creates a microscopically rough enamel surface (enamel tags)
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Acid Etching
A physical process that creates a microscopically rough enamel surface (enamel tags)
first successful technique developed to bond dental materials to tooth structure
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Acid Etching
A physical process that creates a microscopically rough enamel surface (enamel tags)
first successful technique developed to bond dental materials to tooth structure
acid used id 37% ortho-phosphoric acid
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sometimes referred to as conditioner
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Enamel Etching
![Page 219: class iv direct composite](https://reader031.fdocuments.us/reader031/viewer/2022020116/55a06ccb1a28abc17f8b45a7/html5/thumbnails/219.jpg)
Enamel EtchingAcid
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Enamel EtchingAcid 37% ortho-phosphoric acid
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Enamel EtchingAcid 37% ortho-phosphoric acid dissolves the periphery of enamel
rod, or the core of the rods or both
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![Page 223: class iv direct composite](https://reader031.fdocuments.us/reader031/viewer/2022020116/55a06ccb1a28abc17f8b45a7/html5/thumbnails/223.jpg)
over-etching results to formation of crystals (precipitates) that inhibits bonding
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over-etching results to formation of crystals (precipitates) that inhibits bonding
built-in quality control check – if properly etched it appears frosty or chalky white.
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over-etching results to formation of crystals (precipitates) that inhibits bonding
built-in quality control check – if properly etched it appears frosty or chalky white.
Time
![Page 226: class iv direct composite](https://reader031.fdocuments.us/reader031/viewer/2022020116/55a06ccb1a28abc17f8b45a7/html5/thumbnails/226.jpg)
over-etching results to formation of crystals (precipitates) that inhibits bonding
built-in quality control check – if properly etched it appears frosty or chalky white.
Time 15-30 seconds permanent tooth
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over-etching results to formation of crystals (precipitates) that inhibits bonding
built-in quality control check – if properly etched it appears frosty or chalky white.
Time 15-30 seconds permanent tooth twice as long for deciduous
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Dentin Etching
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Dentin EtchingAcid
![Page 231: class iv direct composite](https://reader031.fdocuments.us/reader031/viewer/2022020116/55a06ccb1a28abc17f8b45a7/html5/thumbnails/231.jpg)
Dentin EtchingAcid 37% ortho-phosphoric acid
![Page 232: class iv direct composite](https://reader031.fdocuments.us/reader031/viewer/2022020116/55a06ccb1a28abc17f8b45a7/html5/thumbnails/232.jpg)
Dentin EtchingAcid 37% ortho-phosphoric acid removes the smear layer from the
surface of the of the dentin as well as the plugs of material forces into dentinal tubules during cavity preparation.
![Page 233: class iv direct composite](https://reader031.fdocuments.us/reader031/viewer/2022020116/55a06ccb1a28abc17f8b45a7/html5/thumbnails/233.jpg)
![Page 234: class iv direct composite](https://reader031.fdocuments.us/reader031/viewer/2022020116/55a06ccb1a28abc17f8b45a7/html5/thumbnails/234.jpg)
decalcifies a layer of dentin several microns thick
![Page 235: class iv direct composite](https://reader031.fdocuments.us/reader031/viewer/2022020116/55a06ccb1a28abc17f8b45a7/html5/thumbnails/235.jpg)
decalcifies a layer of dentin several microns thick
Time
![Page 236: class iv direct composite](https://reader031.fdocuments.us/reader031/viewer/2022020116/55a06ccb1a28abc17f8b45a7/html5/thumbnails/236.jpg)
decalcifies a layer of dentin several microns thick
Time10-15 seconds
![Page 237: class iv direct composite](https://reader031.fdocuments.us/reader031/viewer/2022020116/55a06ccb1a28abc17f8b45a7/html5/thumbnails/237.jpg)
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Primer
![Page 239: class iv direct composite](https://reader031.fdocuments.us/reader031/viewer/2022020116/55a06ccb1a28abc17f8b45a7/html5/thumbnails/239.jpg)
Primer
similar to the low viscosity resin used in enamel bonding.
![Page 240: class iv direct composite](https://reader031.fdocuments.us/reader031/viewer/2022020116/55a06ccb1a28abc17f8b45a7/html5/thumbnails/240.jpg)
Primer
similar to the low viscosity resin used in enamel bonding.
primers are hydrophilic (tolerant of moisture)
![Page 241: class iv direct composite](https://reader031.fdocuments.us/reader031/viewer/2022020116/55a06ccb1a28abc17f8b45a7/html5/thumbnails/241.jpg)
Primer
similar to the low viscosity resin used in enamel bonding.
primers are hydrophilic (tolerant of moisture)
contains a volatile solutions (acetone) to thin the organic chemicals and improves the wetting of the etched surface
![Page 242: class iv direct composite](https://reader031.fdocuments.us/reader031/viewer/2022020116/55a06ccb1a28abc17f8b45a7/html5/thumbnails/242.jpg)
primer flows into:
![Page 243: class iv direct composite](https://reader031.fdocuments.us/reader031/viewer/2022020116/55a06ccb1a28abc17f8b45a7/html5/thumbnails/243.jpg)
primer flows into: -surface irregularities of etched
enamel
![Page 244: class iv direct composite](https://reader031.fdocuments.us/reader031/viewer/2022020116/55a06ccb1a28abc17f8b45a7/html5/thumbnails/244.jpg)
primer flows into: -surface irregularities of etched
enamel-open tubules and around collagen
fibers of etched dentin
![Page 245: class iv direct composite](https://reader031.fdocuments.us/reader031/viewer/2022020116/55a06ccb1a28abc17f8b45a7/html5/thumbnails/245.jpg)
primer flows into: -surface irregularities of etched
enamel-open tubules and around collagen
fibers of etched dentin primers do not set on their own, et
when adhesive is applied
![Page 246: class iv direct composite](https://reader031.fdocuments.us/reader031/viewer/2022020116/55a06ccb1a28abc17f8b45a7/html5/thumbnails/246.jpg)
Adhesives
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Adhesives
a low viscosity resin
![Page 248: class iv direct composite](https://reader031.fdocuments.us/reader031/viewer/2022020116/55a06ccb1a28abc17f8b45a7/html5/thumbnails/248.jpg)
Adhesives
a low viscosity resin dentin adhesives contain hydrophilic
chemicals, but less than in primers
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Adhesives
a low viscosity resin dentin adhesives contain hydrophilic
chemicals, but less than in primers adhesive sets
![Page 250: class iv direct composite](https://reader031.fdocuments.us/reader031/viewer/2022020116/55a06ccb1a28abc17f8b45a7/html5/thumbnails/250.jpg)
Adhesives
a low viscosity resin dentin adhesives contain hydrophilic
chemicals, but less than in primers adhesive sets renders the tooth surface glossy
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Two-step Bonding System
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Two-step Bonding System the primer and the adhesive have
been combined
![Page 253: class iv direct composite](https://reader031.fdocuments.us/reader031/viewer/2022020116/55a06ccb1a28abc17f8b45a7/html5/thumbnails/253.jpg)
Two-step Bonding System the primer and the adhesive have
been combined
One-step/Self Etching System
![Page 254: class iv direct composite](https://reader031.fdocuments.us/reader031/viewer/2022020116/55a06ccb1a28abc17f8b45a7/html5/thumbnails/254.jpg)
Two-step Bonding System the primer and the adhesive have
been combined
One-step/Self Etching System etches, primes and bonds (has
adhesives) the tooth structure all at once
![Page 255: class iv direct composite](https://reader031.fdocuments.us/reader031/viewer/2022020116/55a06ccb1a28abc17f8b45a7/html5/thumbnails/255.jpg)
Two-step Bonding System the primer and the adhesive have
been combined
One-step/Self Etching System etches, primes and bonds (has
adhesives) the tooth structure all at once
sometimes does not effectively etch the enamel.
![Page 256: class iv direct composite](https://reader031.fdocuments.us/reader031/viewer/2022020116/55a06ccb1a28abc17f8b45a7/html5/thumbnails/256.jpg)
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Restorative Technique
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Restorative Technique
1. Determine shade of tooth
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Shade Selection:
After caries removal and cavity preparation shade selection was done using shade guide
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Restorative Technique
1. Determine shade of tooth2. Clean the tooth preparation using
a slurry of pumice, polishing cup.
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![Page 262: class iv direct composite](https://reader031.fdocuments.us/reader031/viewer/2022020116/55a06ccb1a28abc17f8b45a7/html5/thumbnails/262.jpg)
Restorative Technique
1. Determine shade of tooth2. Clean the tooth preparation using
a slurry of pumice, polishing cup.3. Isolate the tooth, preferably with a
rubber dam or cotton rolls.
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Isolation of the Teeth:
Rubber dam isolation technique was used to keep the prepared teeth from saliva, blood, debris and other fluids.
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Restorative Technique
1. Determine shade of tooth2. Clean the tooth preparation using
a slurry of pumice, polishing cup.3. Isolate the tooth, preferably with a
rubber dam or cotton rolls.4. Protect adjacent unprepared tooth
from the acid etchant with a polyester strip apply the wedge.
![Page 266: class iv direct composite](https://reader031.fdocuments.us/reader031/viewer/2022020116/55a06ccb1a28abc17f8b45a7/html5/thumbnails/266.jpg)
![Page 267: class iv direct composite](https://reader031.fdocuments.us/reader031/viewer/2022020116/55a06ccb1a28abc17f8b45a7/html5/thumbnails/267.jpg)
5. Apply the gel etchant 0.5 beyond the prepared margins onto the adjacent unprepared tooth.
![Page 268: class iv direct composite](https://reader031.fdocuments.us/reader031/viewer/2022020116/55a06ccb1a28abc17f8b45a7/html5/thumbnails/268.jpg)
5. Apply the gel etchant 0.5 beyond the prepared margins onto the adjacent unprepared tooth.
6. Etchant is left undisturbed for 15-30 seconds.
![Page 269: class iv direct composite](https://reader031.fdocuments.us/reader031/viewer/2022020116/55a06ccb1a28abc17f8b45a7/html5/thumbnails/269.jpg)
Etching Procedure
![Page 270: class iv direct composite](https://reader031.fdocuments.us/reader031/viewer/2022020116/55a06ccb1a28abc17f8b45a7/html5/thumbnails/270.jpg)
5. Apply the gel etchant 0.5 beyond the prepared margins onto the adjacent unprepared tooth.
6. Etchant is left undisturbed for 15-30 seconds.
7. The area is washed to remove the etchant. Same amount of time as etching time.
![Page 271: class iv direct composite](https://reader031.fdocuments.us/reader031/viewer/2022020116/55a06ccb1a28abc17f8b45a7/html5/thumbnails/271.jpg)
8. Dry the tooth structure, if dentin is exposed, do not air dry. Use cotton pellet, disposable brush or tissue paper to remove excess water.
![Page 272: class iv direct composite](https://reader031.fdocuments.us/reader031/viewer/2022020116/55a06ccb1a28abc17f8b45a7/html5/thumbnails/272.jpg)
![Page 273: class iv direct composite](https://reader031.fdocuments.us/reader031/viewer/2022020116/55a06ccb1a28abc17f8b45a7/html5/thumbnails/273.jpg)
8. Dry the tooth structure, if dentin is exposed, do not air dry. Use cotton pellet, disposable brush or tissue paper to remove excess water.
9. Bonding system is applied on all tooth structure that has been etched with a microbrush or other suitable applicators
![Page 274: class iv direct composite](https://reader031.fdocuments.us/reader031/viewer/2022020116/55a06ccb1a28abc17f8b45a7/html5/thumbnails/274.jpg)
10. Air bonding system to thin out coating.
![Page 275: class iv direct composite](https://reader031.fdocuments.us/reader031/viewer/2022020116/55a06ccb1a28abc17f8b45a7/html5/thumbnails/275.jpg)
10. Air bonding system to thin out coating.
11. Cure, follow manufacturer's direction.
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Application of Bonding Agent:
Application of the bonding agent and then cured for 10 seconds.
![Page 277: class iv direct composite](https://reader031.fdocuments.us/reader031/viewer/2022020116/55a06ccb1a28abc17f8b45a7/html5/thumbnails/277.jpg)
10. Air bonding system to thin out coating.
11. Cure, follow manufacturer's direction.
12. Incrementally place composite material and cure.
![Page 278: class iv direct composite](https://reader031.fdocuments.us/reader031/viewer/2022020116/55a06ccb1a28abc17f8b45a7/html5/thumbnails/278.jpg)
Filling
![Page 279: class iv direct composite](https://reader031.fdocuments.us/reader031/viewer/2022020116/55a06ccb1a28abc17f8b45a7/html5/thumbnails/279.jpg)
Filling & Packing
![Page 280: class iv direct composite](https://reader031.fdocuments.us/reader031/viewer/2022020116/55a06ccb1a28abc17f8b45a7/html5/thumbnails/280.jpg)
Curing Of the Composite:
The material is cured using the light curing machine for 20 seconds for every increment of composite that was placed.
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10. Air bonding system to thin out coating.
11. Cure, follow manufacturer's direction.
12. Incrementally place composite material and cure.
13. Finish and Polish
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Finishing and Polishing:
The use of polishers with enhancers and polishing paste were done after the trimming of the excess composites.
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Finishing & Polishing
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Before the restoration procedure.
After restoring with Composite Resin Material
BEFORE AFTERAFTER