Faculty of medicine, Dpt of restorative dentistry, ass.prof. L. Roubalikova1 Restorative dentistry III. 3rd lecture – inlays, veneers Indirect reconstructions Rigid fillings – inlays, onlays • The material is rigid (already cured) Metal alloy, composite, ceramics. Inlays made of the metal alloy (precious alloys) ̶ Manufactured in a dental lab ̶ Direct or indirect method Inlays made of metall alloys are over - Direct method rarely (class I. only) - Indirect method (most cases) ̶ . Inlay Advantages ➢Better anatomic shape ➢Better polished ➢Higer degree of conversion (composite inlays) Inlay Disadvantages ➢The technology is not easy ➢More time consuming ➢Expensive Basic rules of preparation ➢Box ➢ No undercuts ➢ Light divergence of the walls (facilitating shape). Angle of divergency 6 – 15° Box No undercuts Simple box Facilitating shape Retention of rigid fillings Against axial forces, depends on 1. Geometry of the preparation 2. Qwuality of the luting material (cement) Taper Retentiong/mm2 Angle of convergency Rau G. 1994 Non metallic inlays ̶ Composite ̶ Ceramics Indirect method CAD CAM 35 Preparation ̶ Box ̶ No undercuts ̶ Facilitating shape – divergence of the walls appr. 6° ̶ No bevel ̶ Thickness of the material 1,5 – 2 mm Preparation Standard diamond bur Finishing with Fine dimond bur And hand instruments Special diamonds for preparation 10 years composite inlay 10 years ceramic inlay Difrect filling 10 years Direct filling lroubalikova@gmail.com40 Inley or onlay, overlay lenka.roubalikova@tiscali.cz 41 Marginals ridges (sre present or not) Dentine core Supragingival tissues Occlusal forces lenka.roubalikova@tiscali.cz 42 Enamel supported with dentin Sklovina podložena Undercuts are blocked Distance of the cavosurface margin and cusp is more than 1 mm Inlay 43 Enamel is not supported with dentin Distance of the cavosurface margin and the cusp is less than 1 mm Onlay 14.10.2024 44 Preparation rules Thickness pof the materiál 1,5mm - 2 mm Cavosurface angle Funkční stranaNefunkční strana Rules of the preparation Cavity is 2 mm wide, no isthmus, simple lines ̶ 1,5 – 2 mm depth ̶ Gingival wall 1 mm ̶ Ostré margines, round edges inside the cavity ̶ Simple lines ̶ Smooth bottom lenka.roubalikova@tiscali.cz 50 Sealing dentin Closure of dentine tubules Significantly higher retention, protection of dental pulp Bonding agent, flowable removal inhibition layer Finishing with diamodn or /and glycerin gel Impression or scan 14.10.2024 56 Temporary? ̶ Stamp method (Pro Temp) ̶ Proviso or Cavit (one component soft materiál) Sandblasting Aluminium dioxide 50μm Trying Before luting Preparation of hard dental tissues After sandblasting acid etching and bonding Reconstruction ̶ Cleaning after trying (alcohol, or special chemical) ̶ Adhesive preparation acc to the material Lithiumdisilicate ceramics Cleaning Etching Silanization Metal and composite restorations Sandblasting Silanization 14.10.2024 61 14.10.2024 62 Composite cements 63 Cementation ➢Adhesive materials – composite cements ➢Chemically or dual curing low viscosity materials ➢Adhesive systems that must be compatible with adhesive cements 72 lenka.roubalikova@tiscali.cz The cement is covered with glycerin gel Inhibition layer is not present lenka.roubalikova@tiscali.cz 73 Selfcuring cements Panavia 21 (Kuraray) Dyract Cem (DENTSPLY De Trey) Light curing cements ̶ For thin veneers only lenka.roubalikova@tiscali.cz 77 Dual curing cements ̶ Two initiating systems lroubal@med.muni.cz 79 lenka.roubalikova@tiscali.cz 80 Indirect restoration of anterior teeth ̶ Veneers ̶ Crowns ̶ Ceramics ̶ Composits (rare) 81 Indications ̶ Hypoplasia ̶ Diastema, spaced frontal teeth ̶ Discoloration ̶ Multiple filling Definujte zápatí – název prezentace nebo pracoviště82 Contraindications ̶ High caries risk ̶ Bad oral hygiene ̶ Bruxism, deep bite Consider full crown Definujte zápatí – název prezentace nebo pracoviště83 Material ̶ Lithidudisilicate ceramics ̶ Made on model or CAD Cam 84 Preparation – incisal edge involved Definujte zápatí – název prezentace nebo pracoviště85 Acid etching Definujte zápatí – název prezentace nebo pracoviště86 Bonding Definujte zápatí – název prezentace nebo pracoviště87 Adhesive preparation of veneers and crowns Cementation 90 Cementation 91 lenka.roubalikova@tiscali.cz 92 Material ̶ Lithidudisilicate ceramics ̶ Made on model or CAD Cam 93 Luting (cementation) ̶ Adhesive cements ̶ Particles filled composites 94 Contempptrary trends – filling material Transitory decreasing of viscosity Access removal easier Les risk of bubles