Revista de patología y medicina dental.

Abstracto

Odontología restauradora estética biomédica de rendimiento óptimo: un enfoque biomimético - Lori Cardellino, práctica privada

Lori Cardellino

El enfoque de los materiales de restauración dental de moda proporcionó modalidades y materiales de tratamiento electivos a los esfuerzos de reconstrucción basados ??en metal/compuesto convencionales y materiales de conexión/corona. El movimiento del trabajo innovador condujo a una gama de materiales de restauración y prostodóncicos, que van desde acrílicos, silicatos, ionómeros/compómeros, porcelanas reforzadas, producción de cerámica reforzada y compuestos: macrorellenos, microrellenos, partículas pequeñas, razas cruzadas, mitades y mitades de escala miniaturizada y nanorellenos. Todos estos compuestos ofrecen redes de polímeros sin forma/vítreo-brillantes que, debido a su naturaleza débil, se ajustan y restringen a los empastes primarios y posteriores restringidos tradicionales en una inclinación de 1/3 de la cúspide. De aquí en adelante, el avance dinámico de un tratamiento dental de nanocerámica policristalina (PEX) construido biomiméticamente, sin superestructuras de metal prostodóncicas e incrustadas (Diamond Crown/Lite/Flow/Link/Bond). Esta rejilla PEX, proporciona una estructura laminar de morfología de escala más pequeña, macrorrígida/microelástica gruesa, que muestra propiedades físico-mecánicas superiores: calidad de flexión biaxial, calidad de compresión maleable diametral, resistencia al agrietamiento, resistencia al desgaste, soporte de estructura/trabajo/superficie anatómica, seguridad de sombreado, verticalidad despreciable. Estas propiedades físico-mecánicas y estéticas, como la estructura dental normal (ingeniería biomimética), se combinan con similitud tisular, biocompatibilidad, propiedades no citotóxicas: Clase VI de la farmacopea de EE. UU. (citotoxicidad de las sociedades de células de fibroblastos L929, etc.) en escala completamente evaluada: reactividad cero (0). Estas propiedades biocompatibles estéticas de alta tecnología y rendimiento positivo de PEX-Nano Ceram permiten superar el enfoque de rellenos dentales tradicionales restringidos, en un campo de superestructuras terapéuticas de inclusión completa biomiméticas. La evaluación clínica a largo plazo (25 años o más) confirma las evaluaciones Alpha de estructura/trabajo/ejecución estética y similitud tisular de Diamond Crown/Lite/Flow/Link/Bond como una solución ideal para la odontología correctiva, protésica y de implantes. Esta introducción delineará la convención clínica paso a paso y los procedimientos característicos de esta metodología biomédica de rellenos dentales estéticos biomiméticos de tejido perfecto. odontología.

Durante los últimos 15 años, la metodología de recuperación ha evolucionado de manera constante, pasando del mantenimiento mecánico a la fijación de vanguardia. Este cambio fue fomentado por una gran cantidad de distribuciones lógicas, mejoras en los materiales adhesivos y, sobre todo, una difusión general de la ciencia y los procedimientos de la odontología de cola de vanguardia. En general, la ciencia, los estándares y las estrategias de la odontología de cola de vanguardia se conocen como odontología biomimética. En esencia, el enfoque biomimético se refiere a la forma sencilla de pensar de que, para restablecer suficientemente los dientes, debemos "reflejar la vida" y comprender completamente el diente natural.

Coherently, preserving a greater amount of the flawless tooth is vital to this methodology, which matches consummately with grip. Like the flawless regular tooth, an adhesively reestablished tooth is better ready to deal with and oversee utilitarian anxieties. Thus, the biomimetically-reestablished tooth dispenses with holes under rebuilding efforts and splits into dentin that create because of disfigurement and stress focuses, lessening or disposing of postoperative agony and affectability and safeguarding essentialness, as microbes can't attack and execute the mash. The regular adaptability and crack opposition of a tooth are likewise improved when it is hydrated by the crucial mash.

The biomimetic conventions of today are established on the "quiet unrest" of glue dentistry that created during the 80s and 90s.This upheaval was progressed by Japanese scientists who distinguished two unique layers of carious dentin that had two distinct qualities of dentin bond. These scientists had the option to typically cling to dentin by utilizing the novel innovation of a caries recognizing color, which permitted a perfect caries evacuation end-point to be pictured in the exceedingly significant "fringe seal zone."On a dent in surface liberated from denatured collagen, an attach to dentin could be set up utilizing recently created polymerizable monomers that were both hydrophilic and hydrophobic. With these two mechanical advancements, Dr. Takao Fusayama and his group of analysts at the Tokyo Medical and Dental University started the mission for traditionalist, durable cement rebuilding efforts. For the following two decades, proceeded with progresses in materials and procedures took into consideration progressively broad dental imperfections to be reestablished in both the front and back areas of the mouth.

Quick sending to 2002, a milestone book was distributed that best in class significant ideas in biomimetic dentistry, including new data with respect to the properties of normal teeth and their conduct under capacity, arrangement plan standards, and the immeasurably significant basic biomimetic idea of prompt dentin fixing. Around the same time, a procedure to diminish the impacts of polymerization shrinkage stress was distributed, alluded to as a pressure decreased direct composite, which permitted a biomimetic way to deal with an immediate composite reclamation. This article traces the biomimetic ideal models and conventions that are upheld by these and other logical distributions and rehearsed by biomimetic dental specialists around the globe.

Bond-Maximizing Protocols

The subsequent gathering incorporates eight key security expanding conventions, which, when executed, can help accomplish the greatest conceivable security qualities achievable while utilizing the pressure decreasing conventions:

 

Establish a sans caries fringe seal zone. Accomplish a sans caries zone 2mm to 3mm circumferentially around the pit without uncovering the mash. Within the fringe seal zone, caries removal ought to be restricted to a profundity of 5mm, estimated on the long pivot from the cavo-occlusal surface. Estimating from the proximal tooth, the profundity of exhuming ought to be constrained to 3mm from the cavo-proximal surface. Air scrape surfaces. Air scrape composite surfaces for holding/cementation. This will expand bond solidarity to both ordinary and carious dentin. It will likewise change the disappointment mode to wipe out disappointments in the cross-breed layer. When attaching to the composite base of a biomimetic reclamation, air scraped spot will amplify the composite-to-composite bond. evel finish. Angle veneer across lacquer poles to build bond quality. Deactivate network metalloproteinases. This forestalls 25% to 30% of bond quality from being debased. Deactivation can be accomplished by utilizing a 30 second treatment with 2% chlorhexidine (eg Consepsis, Ultradent), benzalkonium chloride (eg Micro-Prime B, Danville or Etch 37, Bisco), or a dent in holding framework with the MDPB monomer (eg SE Protect, Kuraray). Employ highest quality level holding frameworks. Utilize a highest quality level dentin holding framework that can accomplish a microtensile bond quality of 25 MPa to 35 MPa on veneer and 40 MPa to 60 MPa on level dentin surfaces. The accessible information demonstrates that three-advance absolute engraving dentin holding frameworks and two-advance self-carve dentin holding frameworks offer the best clinical presentation. Utilize quick dentin fixing. The application and polymerization of dentin holding operators at the hour of planning (and before an impression is taken) has various points of interest and will at last increment the microtensile bond quality by 400% when contrasted with the conventional methodology of holding the dentin at the cementation arrangement. This is crucial to accomplishing most extreme bond quality. Achieve profound edge height. A sub-gingival box edge should be fortified and raised to a supra-gingival situation to acquire a biomimetic microtensile bond quality more prominent than 30 MPa. This profound edge rise, related to prompt dentin fixing, pitch covering, and the composite "dentin substitution," is alluded to as the "bio-base"— a term utilized by the Academy of Biomimetic Dentistry for the pressure diminished, exceptionally fortified establishment that the aberrant or semi-direct trim or onlay will be clung to.

La motivación detrás del uso de ideas y convenciones útiles biomiméticas es extender la vida útil de los tratamientos dentales correctivos y reducir o eliminar los patrones futuros de retratamiento. Además, la preservación de la estructura dental previene las enfermedades periodontales y la muerte súbita. Los dentistas y los pacientes que eligen la odontología biomimética aprecian estos beneficios todos los días.