Оцінка адаптації крайового прилягання реставраційного матеріалу в зубах з клиноподібними дефектами

Abstract

Досліджувані нами величини насправді надзвичайно малі і визначити пори іншим способом, окрім мікроскопічного неможливо. Проте, під мікроскопом можна помітити ділянки неповної адгезії матеріалу до твердих тканин зубів. Згідно отриманих результатів можна зробити висновки, що ідеальної адгезивної системи не існує. Все ж таки, ми маємо вибирати серед існуючих на ринку адгезивних систем таку, яка найбільш задовольнить потреби стоматологів. За нашими даними такою є адгезивна система 5-го покоління у поєднанні з препарувальним методом лікування клиноподібних дефектів зубів та перетворенням їх у порожнину типу каріозної (з п’ятьма стінками).

Qualitative and long-term restoration of teeth with wedge-shaped defects depends, to a certain extent, on the approaches to their preparation – without the prior preparation of hard fabrics or with the expanded defecation, but they remain completely uncertain. The purpose of the study is to measure the magnitude of adhesion defects of 5th and 7th generation adhesive systems under different tactics of the preparation of hard tissues in teeth with wedge-shaped defects. The object and methods of research. The study was conducted on permanent teeth of a person removed by orthodontic and surgical indications in patients aged 20-45 years. After removal, the teeth were washed under running water, cleaned of blood clots, stored in physiological saline (sodium chloride 9 mg/ml). The teeth were divided into two groups, depending on the 5 generation adhesive system (DC Adhesive NF, Dental Central) and 7 generations (Single bond Universal 3M ESPE). For sealing, composite material “Charisma F”, f. Kulzer. The materials were used according to the recommendations of the manufacturers in accordance with generally accepted methods. Each group was divided into subgroups depending on treatment tactics: 1 subgroup – nonpreparative way. With professional cleaning of teeth surfaces without a fluorine “Deparral neo” without additional preparation. 2 subgroups – shaping the walls of the defect. Grinding the tooth wall with a diamond boron of medium dispersion without violating the shape of the wedge. 3 subgroup – an exfoliate method, with the formation of a spherical or rectangular bottom (depending on the depth) and peripheral to it a parietal wall. 4 subgroup – an exfoliate method, with the formation of a cavity with five walls of the type of carious cavity to improve the retention. The sealed teeth were stored in distilled water at a temperature of (37 ± 2)0 C. The sample was then removed from the water and gently polished it with a grinding paper based on carborundum (average grain size of about 18 μm) to remove from the surface of the seal a layer of about 0.1 mm. Thoroughly washed the sample surface with a jet of water to remove all kinds of waste. With the aid of a horizontal IZA-2 microscope, the maximum length of the largest defect of the adherence of the filling material was observed, which is observed along the wall of the cavity. For testing, 20 specimens were examined for each type of seal. Research results and their discussion. According to the results of the research, the following indicators were obtained. The 5th generation adhesive system, in combination with the preparation method of treating wedge-shaped teeth defects, and their transformation into a cavity of a carious type (with five walls), proved to be the best. In the middle case of defects reached 11.45 microns. In the second place, group 2 was found, where the method of wall polishing of wedge-shaped defects was used in conjunction with the same system – 14.65 μm. Somehow yielded to him the method of the formation of a spherical bottom with a perpendicular wall of the wall – 15.8 microns. Good results have been shown by the treatments with the use of 7th generation adhesive: 19.55 μm – preparation with the formation of five walls, 20.45 μm – grinding method, 20.65 μm – the method of formation of a spherical bottom with a perpendicular to the parietal wall. Unpreparative methods showed the worst results – 27.45 microns – in the 5th generation and 34.05 – in the 7th, respectively. However, these results are also reliable. Conclusions. The quantities we are investigating are actually extremely small, but under the microscope you can see the areas of incomplete adhesion of the material to the hard tissues of the teeth. According to our data, satisfying the needs of dentists adhesive system is the 5th generation in combination with the preparation method of treating wedge-shaped teeth defects and converting them into a cavity of carious type (with five walls).