Morphologic characteristics of dentin at the dentinoenamel junction as viewed by scanning electron microscopy.
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Biomedical subjects
Publications and source records attributed to S Doukoudakis.
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This article discusses a conservative class II amalgam cavity preparation that is similar to a cast onlay preparation except for the absence of the lingual and facial bevels. When extensive decay is removed and undermined cusps are present, onlays from amalgam support tooth structure and prevent fractures. To achieve this, cusps must be reduced to provide for a sufficient bulk of amalgam. The described technique can be applied to class II cavity preparations with weak cusps, class I cavity preparations when the remaining cavity provides adequate retention, and to endodontically treated teeth for which finances do not permit cast restorations.
A shear test was conducted under simulated oral environmental conditions to examine the retention of a new, commercially available modified unfilled resin in comparison with a conventional unfilled resin provided by the same manufacturer. Within the experimental limits of this study no difference was observed between the retention of the conventional and the modified unfilled resins to enamel specimens. However, for dentin specimens the modified resin was clearly superior to the conventional resin, which gave essentially zero retention. With the recommended procedure, the retention of the modified resin to dentin was 13% of that for the retention of either resin to enamel. It was also observed microscopically that the new resin demonstrated good wetting ability of the dentinal surface. The retention of the two resins to dentin with various surface treatments was determined. The recommended surface preparation procedures of cleaning the dentin surface with hydrogen peroxide followed by a water rinse gave equivalent, if not superior, results to a 1-minute etch with phosphoric acid or citric acid followed by a water rinse.
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The purpose of this article is to describe and discuss a modified amalgam onlay preparation which is a conservative approach to restoring extensively decayed teeth. The cavity preparation for the amalgam restoration appears similar to a preparation for a cast restoration and at the same time the preparation provides a 90 degree cavosurface bevel. The amalgam onlay preparation may be used in any class 1 or class 2 cavity preparation when the cusps are weak and should be protected by the restorative material. The modification of the cavity which is the angulation of the buccal and the lingual walls provides convenience to the clinician during the condensation and carving of the amalgam. In addition to this the natural contours of the tooth are preserved and in cases of upper posterior teeth the buccal surface of the cusps is almost completely preserved and the appearance of the amalgam is not different from that of a gold onlay restoration.
A Tofflemire matrix is modified and is secured in place with the help of Super Floss and unfilled light-activated resin or light-activated impression material. The matrix prevents excess cementing medium escaping in the gingival area, providing excellent isolation. The technique is simple and provides good esthetics while minimizing lengthy and traumatic finishing procedures.
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Ensuring adequate approximal contacts when performing class 2 composite resin restorations is a significant challenge for the dentist. Fabrication of custom composite cylinders for placement into prepared cavity preparations enables the dentist to wedge the matrix band firmly against adjacent teeth, as well as eliminating the curing contraction variable that occurs when composite restorations are placed. Thus, predictable approximal contacts are obtained when class 2 composite restorations are completed.