Recent breakthroughs in restorative dentistry.
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Biomedical subjects
Publications and source records attributed to J B Heyde.
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There is a definite need for an esthetically acceptable conservative treatment to correct the disfiguring appearance of malformed and discolored teeth. This type of dental disturbance can introduce a grave psychologic effect on the patient. With the use of a specially shaded resin material, a thin plastic veneer, and an acid etch technique, an esthetic and functional restoration can be produced that will give the dentist and the patient consistently acceptable clinical results. The technique is essentially reversible and requires minimal or no tooth reduction, except where necessary for caries removal.
A new two-paste composite system (Vytol and Vytol Bonding Agent) was evaluated to establish its level of pulpal response in human teeth and to determine whether a calcium hydroxide base is required. Class V cavity preparations were cut in seventy-two teeth of ten male patients whose ages averaged 52.5 years. The teeth were restored and extracted at 1 to 7 days, 12 to 14 days, and 47 to 56 days. Histologic evaluation indicated that the unlined Vytol System reacted very similarly to other commercially available composite restorative materials and that a calcium hydroxide base is effective in reducing or eliminating adverse pulp responses.
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The results of this study, plus those of a previous study, show that a layer of CaOH lining the floor of the tooth cavity will protect the dental pulp against toxic irritants inherent to an UV light-polymerized cavity liner and a UV light-polymerized composite restorative resin. This study also showed that a layer of CaOH lining the floor of the cavity will protect the dental pulp against acid irritants inherent in the enamel etching solution. It is recommended to restorative dentistry that all primary dentin within clinically accessible areas of the cavity preparation be covered with a layer of CaOH before the enamel is etched with the acid-conditioning solution. Precautionary protection of primary dentin in this manner affords a margin of safety should the conditioning solution inadvertently spill onto the primary dentin during the enamel-etching procedure. Second, if the conditioning solution does accidentally spill onto the previously placed protective layer of CaOH during the enamel-etching procedure, then it logically follows that this acid-contaminated layer of CaOH should be mechanically removed and a new layer of CaOH that completely lines at least the floor of the tooth cavity should be placed before the resins are applied.
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