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1.

Materiale pentru obturaii de baz


2. Materiale restaurative utilizate n stomatologia pediatric
3.Adezivii utilizai n stomatologia pediatric

Obturaiile de baz
Au o grosime de 1,5- 2 mm

Rol:
1. Protecie mecanic

2. Protecie termic a pulpei


3. Rol de suport mecanic pentru materialul
de reconstituire coronar

Obturaiile de baz

Are rolul de a nlocui dentina pierdut n


urma preparrii cavitii
De aceea pot fi utilizte o serie de cimenturi
dentare clasice i moderne, aceleai care
se pot folosi i la odontologie
Fa de lineri se prepar cu consistene
mai crescute

Obturaiile de baz= cimenturi

Cimenturile utilizate ca obturaii de baz


trebuie s ndeplineasc o serie de condiii:
1. s fie netoxice, neiritante pentru pulp i
alte esuturi
2. S fie capabile s protejeze pulpa de
efectul materialelor de reconstituire
3. S asigure o izolare termic pt protejarea
pulpei de variaiile termice (rolul de izolator
termic e proporional cu grosimea)
4. S asigure protecia chimic: cimentul s
mpiedice penetrarea n dentin a
substanelor toxice pulpare din materialele
de reconstituire

Obturaiile de baz= cimenturi

Cimenturile utilizate ca obturaii de baz


trebuie s ndeplineasc o serie de condiii:
5. s asigure o izolare electric, pentru a
reduce efectul curenilor galvanici asupra
pulpei
6. S aib efect antibacterian
7. S adere de esuturile dentare i s
asigure aderena i fa de materialul de
reconstituire
8. S prezinte proprieti reologice care s
asigure o fluiditsate optim i un timp de
lucru adecvat

Obturaie de baz cu CIS:

Pregtirea cimentului FOZ:

Bazele de ZOE, PCZ, CIS i CIMR realizeaz o


bun protecie chimic.

!!! Trebuie luate precauii la cimenturile FOZ


care trebuie preparate ntr-o consisten
chitoas (astfel riscul de iritaie pulpar e
minim) iar zonele profunde trebuie protejate
cu ciment pe baz de hidroxid de Ca!

1.

2.

3.

Spatule pentru ciment:

Pregtire FOZ: metoda plcuei rcite

Aparat pentru nclzire/rcire


(Panel termodinamic):

Exemplu: nclzirea anestezicului la 37C

Prenclzirea oglinzii pentru a preveni aburirea acesteia

Aplicare CIS

CIS radioopac

Aplicare CIS:

Alegerea materialului de obturaie de


baz n pedodonie e influenat de:
Clasa cavitii

Tipul materialului restaurativ utilizat (de ex


sub amalgam baza trebuie s rezista presiunii de
condensare a materialului restaurativ; dac baza
se fractureaz sau se deplaseaz la inserarea
amalgamului, nu va mai fi de ex protecie
termic)
Profunzimea cavitii
Interaciunile dintre materialele utilizate (ex:
se evit baza de ZOE n asociere cu compozitul)

Cimenturile n pedodonie sunt


utilizate pentru:
1. Obturaii de baz i cptuirea pereilor
nesuinui n caviti extinse, mai ales la
dd permaneni tineri
2. Protecia plgii pulpo-dentinare

3. cimentarea coroanelor sau a inelelor


pedodontice

Cimenturi ZOE:
Clasificare:
Tipul I (fixri provizorii)
-Clasa 1: pulbere + lichid
-Clasa 2a: past+ past care se ntrete cu
eugenol
-Clasa 2b: past+past care se ntrete fr
eugenol
-Clasa 3b: past +past care nu se ntrete

Clasificare ZOE:
Tipul II (fixri permanente):

Clasa 1: pulbere + lichid

Tipul III (baze i obturaii provizorii)


Clasa 1: pulbere + lichid
Clasa 2: past + past
Tipul IV (lineri)
Clasa 1: pulbere + lichid
Clasa 2: past + past

Folosite n
pedodonie

Produi comerciali:
Kalsogen (De Trey)

Kalsogen Plus (De Trey)


IRM (Caulk)
Cavitec (Kerr)

Folosite pentru
baze inremediare

Kalsogen Plus (De Trey)

Kalsogen Plus (De Trey)


Kalsogen Plus contains eugenol which has a

sedative action for diminishing pain. The


material is a fine powder which mixes easily into
liquid without tackiness. The dense consistency
ensures the product acts as a good thermal and
chemical insulator.

Mixing time: 1 to 1 minutes


Working time: 2 minutes
Setting time: 3 minutes
Mixing Ratio: Powder liquid ratio, 4.5:1 (by
weight)

Kalsogen (De Trey)

Kalsogen (De Trey)


Description and Features :
A Zinc Oxide / Eugenol formulation.
Therapeutic properties - ideal for sensitive cavities.
Effective insulation under cements and amalgams
against thermal change and irritation.

Indications for use :


For lining under non-resin filling materials.
As a temporary filling material and cement.

IRM:

IRM is an intermediate restorative material, composed of

polymer reinforcement zinc oxide-eugenol (ZOE). IRM is


recommended for many applications, including restoration

IRM capsule

Among the many applications are:


- restoration of deciduous teeth (when permanent teeth are
two years or less from eruption);
- restorative emergencies;
- caries management program;
- dental school clinics and public health dental programs.

Handling characteristics IRM powder and liquid should be mixed in less than
one minute. The resulting putty consistency is then inserted into the cavity. If
indicated, conventional methods of matrix application are appropriate.

Cavitec , Dycal

ZOE pentru fixri provizorii:


Opotow Trial cement (Teledyne)

Opotow Temporary Cement


(Teledyne)

Temp-Bond (Kerr)

Kerr (UK) Ltd have launched Temp-Bond Clear, a new


dual cure temporary cement:

The main benefit of the


product is its translucence,
ensuring that there is no
dull (mat) cement showthrough, resulting in better
aesthetics.
A Fast dual curing
mechanism means the
cement sets in 4 minutes.

Scutabond nF (3M ESPE)


pentru fixri provizorii:

Caryosan (Spofa)
pt coafaje, obturaii provizorii

CARYOSAN
Zinc oxide-eugenol cement
Characteristics and advantages
- analgesic and bactericidal effect
- Diagnostic filling the symptoms will go off in case of reversible pulpitis
- good biocompatibility
- excellent capability to fulfil the root canal
- good marginal seal of temporary filling

Indications
- temporary fillings
- cement bases in cavities close to pulp
- permanent root fillings with gutta-percha posts

Obturaie provizorie cu ZOE


Ciment ZOE

Ciment non eugenol de lipire


Description
Harvard TEMP Zinc Oxide Luting Cement
Temporary luting of permanent & provisional crowns & bridges
Optimal adhesion
Excellent flow behaviour
Eugenol free & therefore no curing inhibition of composites

! Atenionare
Utilizarea concomitent a materialelor pe
baz de ZOE i hidroxid de Ca este
contrindicat pt c eugenolul chelateaz
ionii de Ca

Linerii pe baz de ZOE nu se folosesc


direct sub obturaiile cu RDC pt c inhib
reacia de polimerizare

Se recomand folosirea cimenturilor ZOE


modificate cu polimeri, cimenturi EBA, HVEBA (armare cu esteri vanilai) n
urmtoarele situaii:
- obturaii de baz (nu asociate cu RDC)

- fixri provizorii sau de durat


-reconstituiri coronare provizorii
-reconstituiri la dinii temporari

Cimenturi fosfat de zinc (FOZ)


Folosite n pedodonie
Pentru obturaii de baz
Reconstituirea leziunilor coronare ale dinilor temporari

Specificri:
Preparare: consisten chitoas (ferm)
!! Amestecul proaspt de FOZ e f acid (poate irita pulpa, de

aceea nu se folosesc n caviti profunde)


Nu ader de esuturile dure dentare

Reprezentani comerciali:
Harvard Cement (Richter& Hoffman Harvard Dental)

Zinc Cement (SS White)


Ciment Ames (Teledyne)
De Trey Zinc (De Trey)

Adhesor (Spofa)
Hy-Bond (Shofu)
Flecks (Mizzy)

PhosphaCem PL (Vivadent)

Harvard Cement

Harvard Cement capsule:


Indications

Zinc phosphate cement in capsules for permanent luting of crowns and


bridges, inlays and onlays on natural core and for luting supraconstructions on
implants
For crowns and bridges made of:
- Zirconia
- Aluminium oxide
- Lithium disilicate
- Silicate ceramic
- For all classical metal and metal-ceramic materials

Properties
Consistent application with only 10 seconds mixing time in normal
high frequency mixer / amalgamator
Direct and precise application of creamy, totally homogeneous
cement on the restoration
Avoids mistakes in mixing and dosing
Sufficient for luting of 1 2 crowns from each capsule
Working time of about 2 3 minutes at 23 C

Flecks (Mizzy)

Hy-Bond (Shofu)

Heraeus Kulzer Phosphate Cement

Cimenturi fosfat de zinc antiseptice:


Variante cu adaosuri de oxid de cupru (CuO)
CuproDur (Merz)
Kupferzement (De Trey)

Cu sruri de Ag
Argil (Spofa)
Germicidal-Kriptex (SS White)
Alte adaosuri: fluor, oxid de cobalt, oxalat
de Cu, sulfat de Cu etc

Cupro Dur (Merz)

Cimenturi PCZ
Indicaii:

- Tipul I (pentru fixare, lipire) pt fixarea,


lipirea atelelor de imobilizare, lipirea inelelor
ortodontice
- Tipul II (Obturaii de baz i alte utilizri):
obt de baz, lineri, refaceri de bonturi,
obturaii pe dinii temporari

Reprezentani:
Durelon (3M ESPE)

Durelon Maxicap (3M ESPE)


Poly-F-Plus (Dentsply)
Carboxylate Cement (Bayer dental)

Durelon F Plus (3M ESPE)


Durelon Maxicap (3M ESPE)

Durelon (3M ESPE)

Lineri pe baz de cimenturi


ionomere i compomeri
CIS tradiional pulbere+ lichid (tip III)

-au o vscozitate iniial mai redus,


reacie de priz rapid

Ketak bond Aplicap (capsule)


(3 M ESPE)

|Diamond (Kemdent)

Lineri pe baz de cimenturi


ionomere i compomeri
Cimenturi modificate cu rini (tip III) sau
lineri CIMR care pot fi:
1. sistem bicomponent pulbere+ lichid
2. sistem monocomponent (past)
Tehnica care utilizeaz lineri-ionomeri n

asociere cu materiale compozite se


numete tehnica sandwich

tehnica sandwich

Ionolux (Voco) glasionomer

Atenionare!
Rezistena la traciune i compresiune a
linerilor pe baz de cimenturi ionomere de
sticl (tip III)e mai mic dect a
cdimenturilor restaurative (tip II)

Compomerii ca materiale
de obturaie de baz
Sunt materiale hibride situate ntre CIS i
compozite (dpdv chimic sunt rini
modificate cu poliacizi)
Primul compomer: Dyract (De Trey)

Are o radioopacitate de 2,5X mai mare dect a dentinei

Compomerii ca materiale
de obturaie de baz
Majoritatea sunt monocomponeni
Elibereaz fluor la pH acid (zone cu carioactivitate)
Absena apei e esenial pentru a evita ntrirea

materialului (chiar i n ambalaj)


Au efect cameleonic
Dup priz pot apare modificri dimensionale prin
absorbie de ap, cu o oarecare expansiune a
materialului
Au proprieti mecanice superioare comparativ cu
CIS sau CIMR
Sunt preferai pt obturarea dd temporari , mai ales cu
nu sunt lipicioi
Au sisteme adezive proprii sau similare cu RDC

Reprezentani:

Compoglass (Vivadent)

Hytac (3M ESPE)

Compoglass F (Vivadent)

Adezivii utilizai n
stomatologia pediatric
Se studiaz la TAM (Tehnici adezive moderne- opional)
adezivii de generaia IV, V, VI, VII
Se folosesc i pentru amalgamul adeziv (la dinii
permaneni tineri sau dd temporari)

3M ESPE Adper Easy Bond


Self-Etch Adhesive

Nu a fost elaborat nc materialul de


obturaie ideal, existnd mai multe variante
de reconstituire a leziunilor carioase,
malformaiilor, traumatismelor de la nivelul
dd permaneni tineri i temporari

Materiale restaurative utilizate


n stomatologia pediatric

1.Amalgam de argint
2. CIS tradiional
3. CIS armat (Cermet)
4. Coroane de oel inoxidabil (molari i
canini temporari)
5. Coroane de oel inoxidabil cu faete
polimerice prefabricate (incisivi temporari)
6. RDC
7. CIS modificate cu rini
8. RDC modificate cu poliacizi (compomeri)

http://www.styleitaliano.org/aesthetics-in-posteriors/

NuSmile Signature Crown Preparation Burs are


specifically designed for the steps of tooth reduction
required for successful placement and for finishing of
esthetic pediatric crowns.

The assorted burs within the block provide concise


procedure specific instrumentation for the space
limitations of pediatric dental cases. The burs needed
for both anterior and posterior preparations are also
included

Aplicare ciment de lipire:

The tooth-colored coating on NuSmile


Signature Pediatric Crowns allow clinicians
to offer patients and their parents a more
esthetic restorative option.

NuSmile Signature Pediatric Crowns are made of stainless steel, but they feature a
natural-looking, toothcolored coating for a more esthetic appearance. The crowns are
available in 2 shades and lengths as well as a wide selection of anterior and posterior
shapes and sizes. According to the manufacturer, these comprehensive options help
clinicians provide patients with a more natural smile compared with traditional
stainless steel crowns.
Seven dentists participated in this Dental Product Shopper evaluation of NuSmile
Anterior Pediatric Crowns. They rated and commented on such features as
instructions and training, ease of use and simplicity of technique, and appearance
compared to stainless steel crowns

Training in the placement of NuSmile Anterior Pediatric Crowns includes a


technical DVD that provides a step-by-step demonstration of the clinical
procedure. Instruction focuses on tooth preparation, fitting, and seating of
preveneered crowns for both anterior and posterior cases.
When asked to rate the clarity of instructions and training they received with the
NuSmile Pediatric Crowns, 2 rated them as excellent, 4 rated them as very good,
and 1 rated them as good. An evaluator from Enid, OK said, Training was
extensive and complete. This same evaluator, who said he would definitely
purchase NuSmile Anterior Pediatric Crowns in the future and recommend them
to colleagues, noted Placement is similar to [another companys] crown
placement, but the training from NuSmile on placement of their crowns is
superior.

According to the manufacturer, NuSmiles single appointment, easy placement


technique increases productivity and reduces operatory time. In addition, the
crowns are said by NuSmile to be less technique-sensitive than other treatment
options.
Two evaluators rated ease of use as excellent and 5 rated it as very good. With regard
to simplicity of the NuSmile Crown technique, 3 of the evaluating dentists rated it as
excellent and 4 rated it as very good.

A 2007 study published in the journal Pediatric Dentistry indicated that


NuSmile Crowns have proven durability, color stability, and high parent
satisfaction, making them a top choice of most pediatric dentists.1 Two
additional studies have demonstrated that a majority of pediatric dentists
choose NuSmile Crowns for esthetic restoration with full-coverage
protection in cases of early childhood caries.2,3
When asked to rate the esthetics of NuSmile Anterior Crowns, 3
evaluators rated them as excellent, 1 rated them as very good, and 3 rated
them as good. With regard to the appearance of the NuSmile Crowns
compared to stainless steel crowns, all 7 of the evaluators rated NuSmile
as excellent, giving them a perfect score in this category.