340 likes | 385 Views
ทพญ. วสุ นธรี ขันธรรม ทันตก รรม สำหรับเด็ก โรงพยาบาลนคร พิงค์ เชียงใหม่. Glass ionomer restorative cement systems: An update. Berg JH, Croll TP, 2015. Restorative objectives for children. Sealing noncarious pits and fissures
E N D
ทพญ.วสุนธรี ขันธรรม ทันตกรรมสำหรับเด็ก โรงพยาบาลนครพิงค์เชียงใหม่ Glass ionomer restorative cement systems: An update Berg JH, Croll TP, 2015
Restorative objectives for children • Sealing noncarious pits and fissures • Rendering the tooth and the restoration interface caries resistant after tooth repair • Easy handling properties • Cost resonable
Disadvantage • Lower wear resistance and physical properties compare to composite • Moisture sensitive remain • Unstable color
Introduction • SMART=ART • A simplified and modified atraumatic restorative treatment • To remove caries and minimal preparation using only hand instruments and fill it with glass ionomer cement • Without fear
Why SMART? • Slow and gentle technique • More comfortable • No injections or power drills • Field condition • Good alternative in mentally compromised child
Principles • Removing carious tooth tissues using hand instrument only • Restoring the cavity with a restorative material that sticks to the tooth
Cavities suitable • Involving dentin • Accessible to hand instrument • One surface
Contraindications • Pulp disease • Inaccessible to hand instrument
Glass ionomer • Bonds to enamel and dentin • Fluoride release • Easy to use
Update since 2002 • GI best direct application dentin replacement materials • RMGIs • Photopolymerization>> acid/base neutralization reaction • Benefits: • Advantages of GI • Better handling • Greater durability over time • Better physical strength • Wear resistance • Fracture resistance • Fracture toughness
Instruments • Enamel hatchet to open access • Spoon excavators to ease soft dentin • Plastic instrument to applying the GIC and shaping
Procedures 1. Preparing the cavity 2. Isolation
Procedures 3. Access the cavity by enamel hatchet
Procedures 4. Remove soft caries by spoon excavator
Procedures 5. Cleaning the cavity by dentine conditioner 10-15 s 6. Dry with cotton wool 7. GIC inserted
Procedures 8. Carving