Fazal ur Rehman Qazi BDS, FCPS. Asst. Professor Operative Dentistry DIKIOHS,DOW University Karachi
What is Nanotechnology
An emergent science formed from the convergence of chemistry (classically restricted to atomic interaction) and molecular scale physics and biology (previously restricted to the micron scale) Dental update Jan-Feb 2003
Nanofilled Composites Handling Easy finishing and polishing Durability
Preparation for Posterior Composite Restorations
Centric occlusal stops located primarily on tooth structure
No special Preparation for Class 1 Composite Restorations
Margins of the Occlusal Preparation should not be Bevelled
Class 2 Composite Restorations
Prewedging
Beveling for facial and lingual margins of the proximal box
Gingival Margins
Occlusal Margins Placement of occlusal bevels has demonstrated no benefit to the longevity of class 2 resin composite restorations
Cavity Liners with Composite Restorations
Calcium- Hydroxide Liner
Glass-ionomer Liners Improve marginal integrity and decrease marginal leakage (J Dent 1993;21:158-162) Reduce polymerization shrinkage and cuspal deformation(Quintessence Int 1988;19:191-1980 How should composite be layered to reduce shrinkage stress: Incremental or bulk filling? . ( Dental Materials 2008 ; 24 :1501 – 1505)
Glass ionomer liners SEM and microleakage evaluation of the marginal integrity of two types of class V restorations with or without the use of a light-curable coating J Dent. 2008 Nov;36(11):885-91. Epub 2008 Aug 30 material and of polishing.
Dental Composites are much stronger than the liners and bases and are equally insulating JADA 1994;125:687-701 Investigation of the electrical properties of some dental composite restorative materials before and after laser exposure Dental materials 2005 ; vol 22 : 885 - 895
Use of glass ionomer liner on dentine cavity surfaces has shown to significantly reduce postoperative sensitivity Am J Dent 2001;14:34-38
Bonded Base Technique
Techniques to make tight contacts Use of thin sectional matrices Prewedging Prepolymerized composite balls Special wedge shaped composite curing tips.
Do you need to use flowable composite under posterior composite restorations?
The Snow Plow T echnique
Improvements in Dentine Bonding Systems
The wet bonding technique has been repeatedly shown to enhance bond strengths Quintessence Int 2001;32:385-390
Nanotechnology Dental Adhesives
Incorporation of organic solvents like acetone or ethanol
Dentine is air dried collagen fibres collapse
Depending on cavity size, dispense 1 or 2 drops of XENO V into a DENTSPLY CliXdish ™. Picture DFU
In a closed CliXdish XENO V remains useable for up to 30 minutes. Disassemble for cleaning and disinfection . Picture DFU
Apply XENO V twice, wetting all cavity surfaces uniformly with each application. Picture DFU
Then gently agitate the adhesive for 20 seconds. Picture DFU
Evaporate solvent by thoroughly blowing with air for at least 5 sec. Avoid pooling. Picture DFU
Cure for at least 20 seconds. Min. Output Halogen ≥ 500 mW/cm 2 Min. Output LED ≥ 800 mW/cm 2 Picture DFU
Place increments Picture DFU
INCREMENTAL TECHNIQUE
Shrinkage results in interfacial stresses, with the potential for debonding and/or local fracture of tissue or restorative. Shrinkage should be minimised as far as possible. Shrinkage
Light-cure each increment (4 mm) Picture DFU * 10 sec for light output ≥ 800 mW /cm 2 , 20 sec for light output of 500 to 800 mW /cm 2 .
Polishing can be done immediately Picture DFU
Clinical Case
Clinical Case
Core Buildup (Pre-Op)
Core Buildup (Post-Op)
Wear Resistance Clinical Relevance : A low wear rate means that enamel-restorative margins and contact points remain at the correct level, and that gross loss of material does not occur. It goes without saying that a low wear rate is a prerequisite for a modern composite.
Flexural Strength and Modulus Clinical Relevance : The flexural strength of a dental material is an important property since materials may be used in thin layers or in poorly supported edges where flexural forces occur. A high flexural strength is therefore needed.