Restorations of eroded areas

Perioesthetic approach to the diagnosis and treatment of carious and noncarious cervical lesions: Part I

Several factors can contribute to the development of noncarious cervical lesions. Therefore, these lesions can be described and classified according to their primary etiology. Traditionally, most dentists have treated noncarious cervical lesions only with restorative methods, for example, composite resin restorations. However, in many cases, a periodontal or a combined restorative/periodontal approach provides a better esthetic and functional result. In part I of this two-part report, we provide a review of noncarious cervical lesions and a series of clinical case reports showing surgical techniques used and the importance of the periodontal aspect of lesion management.

Perioesthetic Approach to the Diagnosis and Treatment of Carious and Noncarious Cervical Lesions: Part II

Several classes of tooth-colored materials are available for restoring carious and noncarious cervical lesions. Included are the composite resins, which can be bonded into the cervical area to provide predictable form, function, and esthetics. Part I of this two-part report reviewed the etiology of noncarious cervical lesions and provided a series of clinical case reports showing the importance of the periodontal aspect of lesion management. In part II we present information about adhesive preparation design and esthetic restoration of the noncarious cervical lesion.

CLINICAL SIGNIFICANCE

When used with proper attention to preparation design and restoration placement and finishing, resin composites can be used to successfully restore form, function, and esthetics to defective cervical areas of teeth.

Clinical success of cast metal posts and cores

The topic of posts for endodontically treated teeth has received considerable attention in the literature, but there is sparse in vivo research and certain information from in vitro investigations is contradictory. A retrospective study of 1273 endodontically treated teeth in the practices of nine dentists in general practice indicated an inordinately high failure rate with cast posts and cores compared with alternate systems of coronoradicular stabilization. However, a closer evaluation of the data in this study indicated that almost half of the cast posts were half the desired length or less. The indications for the cast post and core are discussed and the specific causes of failure are reviewed. Additional research is needed to compare the success rate of securely seated cast posts and cores with alternate methods of coronoradicular stabilization.

Special matrix for use with glass ionomer in restoring molars with Class V root surface lesions

A simple method of making a custom matrix for molar root lesions has been described. The matrix provides anatomic form to the restoration and reduces the chairside time required to contour and finish the restoration.

Dental composites/glass ionomers: the materials

Most commercial dental composites contain liquid dimethacrylate monomers (including BIS-GMA or variations of it) and silica-containing compositions as inorganic reinforcing filler particles coated with methacrylate-functional silane coupling agents to bond the resin to the filler. They also contain initiators, accelerators, photo-initiators, photosensitizers, polymerization inhibitors, and UV absorbers. Durability is a major problem with posterior composites. The typical life-span of posterior composites is from three to 10 years, with large fillings usually fewer than five years. Polymerization shrinkage and inadequate adhesion to cavity walls are remaining problems. Some pulp irritation can occur if deep restorations are not placed over a protective film. Some have advocated the use of glass-ionomer cement as a lining under resin composite restorations in dentin. The concept of glass-ionomer cements (GICs) was introduced to the dental profession in the early 1970's. Current GICs may contain poly(acrylic acid) or a copolymer. Higher-molecular-weight copolymers may also be used to improve the physical properties of some GICs. Stronger and less-brittle hybrid materials have been produced by the addition of water-soluble compatible polymers to form light-curing GIC formulations. The ion-leachable aluminosilicate glass powder, in an aqueous solution of a polymer or copolymer of acrylic acid, is attacked by the hydrated protons of the acid, causing the release of aluminum and calcium ions. Salt bridges are formed, and a gel matrix surrounds the unreacted glass particles. The matrix is adhesive to mineralized tissues. Provisions must be made for maintenance of the water balance of restorations for the first 24 hours.(ABSTRACT TRUNCATED AT 250 WORDS)