Operative Dentistry Study Guide: Classes III-V
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ScribdTranslationsOperative Dentistry Study Guide: Classes III-V
Translated by
ScribdTranslationsDISCIPLINE OF OPERATIVE DENTISTRY - UNIP
STUDY GUIDE – Preparation and Restoration Class III, IV, V
Composite Resin: Organic Matrix (resinous matrix) + Inorganic Matrix
(load) + silanizing agent (silane)
Classification of composite resins:
MACROPARTICLES: 15 to 100 um / 70 to 80% charge / smaller
contraction / difficult polishing
MICROPARTICLES: 0.01 to 0.05 um / 40 to 50% load / larger
contraction / good polishing
HYBRIDS: macro and microparticles / intermediate properties
MICROHYBRIDS: Intermediate properties / smaller difference in
size between the largest and smallest particles that are hybrid.
NANOPARTICLES: nanotechnology / enhanced properties / good
aesthetic / good polishing / good resistance
Chemically activated resin (paste + paste)
Photoactivated resin (single paste)
ADHESION: it is a force of attraction between two surfaces of compositions
different molecules (in our case, tooth and restorative material),
it can be chemistry or mechanics.
The adhesion in the enamel is already well clarified and accepted. However, enamel and
dentin is a very different structure. Currently, there is a search for
a union to the dentin as satisfying as the one found for the
nail polish.
ADHERENCE TO ENAMEL: acid conditioning of the enamel -
descaling of the prisms - formation of micropores - penetration of
adhesive - micromechanical retention.
ADHESION IN DENTIN:
Smear layer: an amorphous layer of organic and inorganic debris
coming from the cutting or wear of the tooth, as well as oil, blood,
salivary proteins and bacteria, with a thickness of 0.5 to 1.5 m.
ADVANTAGES of smear layer: reduction of sensitivity / decrease of
permeabilidade dentinária / bloqueio à penetração de bactérias / resistência
to the movements of dentin fluids.
DISADVANTAGES of smear layer: persistence of bacteria / Interference
in adhesion / favors marginal microinfiltration
Dentinous structure: Odontoblastic prolongations / Dentin tubules
/ Espaço Periodontoblástico / Dentina Intertubular / Dentina Peritubular /
Humidity
ADHESIVE SYSTEMS:
37% Phosphoric Acid + Primer + Adhesive
Single bottle stickers: phosphoric acid separated/ primer + adhesive in
same bottle
Self-conditioning adhesives: acidified primer + adhesive. It is eliminated
37% phosphoric acid.
The primer has a hydrophilic radical (affinity for dentin) and a
hydrophobic (affinity with the adhesive). It is a bipolar molecule. It may contain
a solvent (alcohol, acetone or ether). It removes the excess moisture from
dentin
The adhesive penetrates the dentin forming the 'tags' (in the tubules) and layers.
hybrid
HYBRID LAYER: intertwining of the adhesive in the collagen fibers of
demineralized dentin.
CLASS III: proximal of anterior teeth without involvement of the angle
incisal.
OPERATION SEQUENCE:
Anesthesia and prophylaxis
2. Color selection (without isolation, natural light, wet teeth)
3. Opening and outline: Spherical diamond tip. Protect neighboring tooth.
Preferably enter through the language. When there is direct access, enter.
by proximal. When the cavity invades the vestibular, enter through the vestibular.
4. Absolute isolation (pre-a-pre)
5. Removal of carious tissue (spherical, low rotation, curettes)
6. Bevel when invading the vestibular (aesthetic)
7. Cleaning of the cavity and pulp protection
8. Placement of the polyester matrix and wedge
9. Acid conditioning (30 sec enamel and 15 sec dentin)
10. Wash and dry
11. Application of primer + adhesive layers. Photopolymerization for 20
seconds
12. Insertion of composite resin increments. Photopolymerization by
40 seconds
13. Removal of isolation. Finishing
Polishing
CLASS IV: Proximal of anterior teeth with involvement of the incisal angle
Often related to fracture. Does not require opening and
contour. Bevel at the convex surface of the vestibular angle
CLASS V: Cervical third of the buccal and lingual surfaces of all teeth
Opening with spherical diamond tip or carbide 245.
Bevel (do not bevel the gingival wall)