Class II direct composite resin restorations with beta-quartz glass-ceramic inserts.
ABSTRACT With the increasing demand for esthetic posterior restorations, numerous techniques have been developed. The direct resin restoration has probably been used most extensively in Class II situations. Problems with Class II direct resin restorations include difficulty in developing proximal contact, occlusal wear, and polymerization shrinkage. Beta-quartz glass-ceramic inserts have been developed in an attempt to reduce the incidence of these potential problems. They can be placed in a one-appointment technique, are relatively inexpensive, and can readily be utilized by the clinician adept in placing Class II composite resin restorations.
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ABSTRACT: Stress generation at tissue/resin composite interfaces is one of the important reasons for failure of resin-based composite (RBC) restorations owing to the inherent property of polymerization shrinkage. Unrelieved stresses can weaken the bond between the tooth structure and the restoration, eventually producing a gap at the restoration margins. This can lead to postoperative sensitivity, secondary caries, fracture of the restorations, marginal deterioration and discoloration. As polymerization shrinkage cannot be eliminated completely, various techniques and protocols have been suggested in the manipulation of, and restorative procedures for, RBCs to minimize the shrinkage and associated stresses. Introduction of various newer monomer systems (siloranes) may also overcome this problem of shrinkage stress. This review emphasizes the various material science advances and techniques advocated that are currently available or under trial/testing phase to deal with polymerization shrinkage in a clinical environment. Clinical Relevance: Minimizing the shrinkage stresses in RBC restorations may lead to improvement in the success rate and survival of restorations. Thus, it is important for dental practitioners to be aware of various techniques and materials available to reduce these shrinkage stresses and be updated with the current knowledge available to deal with this issue.Dental update 03/2010; 37(2):115-8, 120-2, 124-5.
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ABSTRACT: summary Ceramic inserts are reported to possibly reduce polymerization shrinkage for posterior resin composite fillings. The aim of the present investigation was to evaluate the effect of different insert systems before and after thermomechanical loading. Sixty sound human third molars received occlusomesial Class II cavities, 40 with proximal margins 2 mm above and 20 with proximal margins 1 mm below the cementum-enamel junction. The specimens were randomly assigned to one of the six experimental groups (n = 10). The enamel-bordered cavities were restored with Syntac classic and Tetric Ceram (ST), Syntac classic, Tetric Ceram and beta-quartz inserts (TB), Syntac classic, Tetric Ceram and Cerana inserts (TC), Syntac classic, Tetric flow and SonicSys approx inserts (TS). The dentin-limited cavities were filled with Syntac classic and Tetic Ceram (DT), Syntac classic, Tetric flow and SonicSys approx inserts (DS). Before and after thermomechanical loading (100 000 x 50 N, 2500 x 5 degrees C/55 degrees C), replicas were made and both interfaces tooth/composite and insert/composite were examined under a scanning electron microscope at 200x. The Cerana and SonicSys insert groups showed significantly less gaps in enamel (P < 0.05). With beta-quartz inserts, no reduction of gaps was found (P > 0.05). Marginal integrity in dentine-bordered specimens could not be improved with SonicSys inserts (P > 0.05). The bonding performance insert/composite was promising for all IPS Empress inserts (Cerana, SonicSys enamel) but worse for beta-quartz inserts. Regarding gap formation between resin composite and tooth, Cerana and SonicSys inserts significantly reduced gaps. The use of SonicSys inserts in deep proximal cavities cannot be recommended.Journal of Oral Rehabilitation 09/2005; 32(8):606-13. · 2.34 Impact Factor