Adhesive cementation lroubal@med.muni.cz 2 ADHESIVE DENTURES Basic terms, adhesive cementation ➢ Fixed dentures that are fixed using adhesive cementation. ➢ Adhesive dentures: veneers, inlays, onlays, partial crowns, adhesive bridges, conventional crowns and bridges can be also cemented using adhesive cementation. Material: Resin, ceramics, metal lroubal@med.muni.cz 3 Adhesion Ability of two materials to be connected (glue) ➢ Adhesive ➢ Adherend lroubal@med.muni.cz 4 Adhesion ➢ Mechanic ➢ Specific lroubal@med.muni.cz 5 Adhesion ➢ Mechanic Is based on the roughness of the surface lroubal@med.muni.cz 6 Adhesion ➢ Specific Fysical Chemical lroubal@med.muni.cz 7 Adhesion ➢ Specific Fysical – intermolecular forces Van der Waals H- bridges Elektrostatic lroubal@med.muni.cz 8 Adhesion ➢ Specific Chemical binding covalent ion metal lroubal@med.muni.cz 9 Adhesive treatment in dentistry ➢ Sandblasting ➢ Acid etching ➢ Elektrolytic treatment ➢ Laser ➢ Plasma coating ➢ Silanization lroubal@med.muni.cz 10 Adhesive treatment of surfaces in dentistry ➢ Creates irregularities of the surface (roughness) ➢ Increases surface energy ➢ Increases wettability ➢ Combination lroubal@med.muni.cz 11 lroubal@med.muni.cz 12 lroubal@med.muni.cz 13 lroubal@med.muni.cz 14 lroubal@med.muni.cz 15 lroubal@med.muni.cz 16 Adhesion - importance ◼ Making fillings ◼ Cementation ◼ Other (making dentures) lroubal@med.muni.cz 17 Composite cements ➢ Composite materials ➢ Lower viscosity ➢ Selfcuring, dual curing. In special cases also light curing only. Bonding to hard dental tissues (enamel and dentin) ◼ Miromechanically - Acid etching - Selfetching adhesive systems - Selfetsching (selfasdhesive cements) lroubal@med.muni.cz 18 lroubal@med.muni.cz 19 lroubal@med.muni.cz 20 lroubal@med.muni.cz 21 lroubal@med.muni.cz 22 lroubal@med.muni.cz 23 lroubal@med.muni.cz 24 lroubal@med.muni.cz 25 lroubal@med.muni.cz 26 lroubal@med.muni.cz 27 Preparation of surfaces before adhesive cementation ◼ Enamel ◼ Dentin ◼ Ceramic materials ◼ Composite materials ◼ Metal alloys lenka.roubalikova@tiscali.cz 28 Retentive pattern ◼ Periprismatic (Interprismatic) ◼ Intraprismatic ◼ Aprizmatic lenka.roubalikova@tiscali.cz 29 lenka.roubalikova@tiscali.cz 30 TE SE Retentive surface of dentin ◼ Smear layer is removed (modified) ◼ Open dentin tubules ◼ Decalcified collagen network lenka.roubalikova@tiscali.cz 31 lenka.roubalikova@tiscali.cz 32 lenka.roubalikova@tiscali.cz 33 Ceramic materials Silicate ceramics - etchable ◼ Feldspatic ◼ Leucit ◼ Alumina ◼ Lithiumdisilicate Non silicate ceramics non etchable ◼ Vysoce denzní alumina ◼ Zirkonosxde ◼ Highly dense zirkonia ( yttrium stabilized) ◼ Pressed or layered CAD/CAM ceramics lenka.roubalikova@tiscali.cz 34 Less than 15% silicate matrix is not silicate ceramics Ceramic materials Silicate ceramics ◼ Crystals in glass matrix ◼ Etching HF Oxide ceramics ◼ Highly dense material ◼ Sandblasting Al2O3 lenka.roubalikova@tiscali.cz 35 lenka.roubalikova@tiscali.cz 36 Etching Composite and metal surfaces ◼ Sandblasting lenka.roubalikova@tiscali.cz 37 lenka.roubalikova@tiscali.cz 38 Chemical adhesive treatment: ceramics, composite, metal Silanmetacrylate Chemical adhesive treatment of zirconoxide ceramics and non precious alloys lenka.roubalikova@tiscali.cz 39 Phosphatmethakrylate Chemical adhesive treatment of golden alloys lenka.roubalikova@tiscali.cz 40 Sulfidmethacrylate Au----Au----- Au----Au------Au Comprehension Sandblasting plus silane ◼ Metal ◼ Metalceramic (metal) ◼ Zirconia ◼ Composite Etching plus silan ◼ Silicate ceramics lenka.roubalikova@tiscali.cz 41 When adhesive cementation ◼ Area of retention - size ◼ Geometry of preparation lenka.roubalikova@tiscali.cz 42 Angle of convergency Conventional cementation Adhesive cementation 6-15° 15-24° Amount of hard dental tissue – how is the prepared tooth high lenka.roubalikova@tiscali.cz 44 5 mm 3mm Konvenčně Adhezivně lroubal@med.muni.cz 45 Adhesive denures with metal framework lroubal@med.muni.cz 46 Adhesive dentures with metal framework Splints Adhesive bridges lroubal@med.muni.cz 47 Preparation In enamel (0,3 -0,5 mm) Removal of old fillings Adhesion compensates smaller retention area The construction must be primary stable Adhesion is primery mechanical The thickness of the metal framework is 0,5 mm lroubal@med.muni.cz 48 Indication ✓ 1 missing tooth in posterior area ✓ 1 - 2 toth missing in frontal area Conditinos: The gap is not bigger than 2 cm (posterior area) The prognosis of pilots is equal The conditions for adhesive technology are good (dry operating field) lroubal@med.muni.cz 49 Risks and benefits of adhesive dentures with metal framework ➢ Minimly invasive preparation ➢ Aesthetics is not optimal ➢ Risk of secondary caries ➢ Semipermanent solution lroubal@med.muni.cz 50 Adhesive bridge: Maryland bridge Small area for retention Insufficient stabilization lroubal@med.muni.cz 51 Adhesive brisge with the metal framework well stabilized against horizontal forces lroubal@med.muni.cz 52 Adhesive splint with the possibility of replacement of 1-2 teeth lroubal@med.muni.cz 53 Adhesive connection metal cement enamel Sandblasting (Silan) acid etching Adhesive system lroubal@med.muni.cz 54 lroubal@med.muni.cz 55 Ceramic pontic Resin pontic lroubal@med.muni.cz 56 lroubal@med.muni.cz 57 Marginal diskoloration lroubal@med.muni.cz 58 Non metallic adhesive dentures ◼ Inlays, onlays ◼ Inlay bridges ◼ FRC posts lroubal@med.muni.cz 59 + 65 One tooth replacement lenka.roubalikova@tiscali.cz 66 One tooth replacement – adhesive bridge lenka.roubalikova@tiscali.cz 67 Adhesive bridges lenka.roubalikova@tiscali.cz 68lenka.roubalikova@tiscali.cz 69 lroubal@med.muni.cz 70 lroubal@med.muni.cz 71 72 FRC Filler - fibers lenka.roubalikova@tiscali.cz 73 lenka.roubalikova@tiscali.cz Prepregy Vytvrzené dílce 74 FRC x PFC composites Surface friction between matrix and filler – reinforcement Anisotropy Surface fricton is minima Isotropy Always combination lenka.roubalikova@tiscali.cz Products lenka.roubalikova@tiscali.cz One tooth replacement Location of FRC Preparation Adhesion Placement of the arteficial tooth PFC composite on the top lenka.roubalikova@tiscali.cz lenka.roubalikova@tiscali.cz lenka.roubalikova@tiscali.cz lenka.roubalikova@tiscali.cz lenka.roubalikova@tiscali.cz lenka.roubalikova@tiscali.cz lenka.roubalikova@tiscali.cz lenka.roubalikova@tiscali.cz lenka.roubalikova@tiscali.cz FRC posts – postendo treatment lenka.roubalikova@tiscali.cz 88 White Light lenka.roubalikova@tiscali.cz lenka.roubalikova@tiscali.cz lenka.roubalikova@tiscali.cz Individually made FRC posts lenka.roubalikova@tiscali.cz Poděkování: Prof. MUDr. Jiřímu Vaňkovi, CSc. Ing Zbyňkovi Šedivému Ing Aleši Matouškovi MUDr. Ladislavu Gregorovi. Práce vychází z projektu MŠMT1M0528 lenka.roubalikova@tiscali.cz Repair od dentures lenka.roubalikova@tiscali.cz Zdroj obrázku: Manuál Fast Splint, BCM, Francie Repair od dentures lenka.roubalikova@tiscali.cz Reinforcement Zdroj: Manuál Fast Splint, BCM, Francie lenka.roubalikova@tiscali.cz Products lenka.roubalikova@tiscali.cz