Intracoronal restorations--part II: indirect procedures.
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Biomedical subjects
Publications and source records attributed to Douglas A Terry.
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Advances in restorative material formulations and adhesive technology have expanded and created new treatment possibilities for dental practitioners. Due to this evolution, composite resins are being used with increasing frequency in posterior restorations. In order to successfully place these restorations, the clinician must understand the rationale for restorative material selection, preparation design, adhesive protocol, and composite resin placement. This article illustrates these considerations for placing a Class I posterior composite restoration.
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In this era of modern adhesive dentistry, clinicians are still faced with challenges from microleakage, recurrent decay, and sensitivity. Many of the challenges are a result of using yesterday's restorative techniques and principles with the new formulations of biomaterials. Procedures such as the proximal adaptation and the oblique layering techniques offer modifications to the nonadhesive principles discussed in Part I (The Compendium, December 2004), while providing the patient and clinician with the 3 primary objectives of restorative dentistry: prevention, preservation, and conservation. Using stratification techniques and thorough adhesive protocol as illustrated in this article allows clinicians to provide restorations that have improved physical characteristics while reducing the effects of polymerization shrinkage. Other benefits of these adhesive procedures include enhanced chromatic integration, ideal anatomical form and function, optimal proximal contact, improved marginal integrity, and longer lasting directly placed composite restorations.
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The metallic restorative materials of the past required the dentist to focus on function and form because metal had no tooth-colored properties. The development of tooth-colored restorative materials has introduced a new element in the restorative equation--color. Unfortunately, many clinicians continue to apply a "metallic mentality" to restorative techniques with the newer adhesive restorative materials that can produce a tooth-colored appearance. With advances in material sciences and adhesive technology, the restorative concept now includes aesthetics as a variable in the restorative equation as well.
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