POSTERIOR FILLINGS, INLAYS AND OVERLAYS Dr Tom Bereznicki BDS (Edin)
PROFESSIONAL INFLUENCES • • • • • • • • • • • • •
Jan Lindhe & Sture Nyman Shillingburg, Hobo, Whitsett Jan Pameijer Peter Dawson Ronald Goldstein John Kanca 111 David Garber & Team Atlanta Gordon Christiansen Carl Misch Harold Preiskel John McLean & Mick Kedge Eddie Levinson Michael Wise
Prof Stephen Dunne
MINIMALLY INVASIVE DENTISTRY LEARNING FROM FAILURE
42 year old amalgam restorations
19 YEAR OLD AMALGAM CROWN
WHITE FILLINGS IN ANTERIOR TEETH
Composites simply do not bond long-term to Dentine
27 year old glass ionomer
5 year bonded composite
DENTISTRY TODAY – VOL 35 No 7 P 126 THE ‘RESERVOIR RESTORATIVE’ REVOLUTION
WHITE FILLINGS IN POSTERIOR TEETH
Total etch/wet bonding v self etch bonding
? USE A GI OR RMGI BASE?
JIFFY BRUSHES
RECURENT DECAY
RECURRENT TOOTH DECAY BENEATH A ‘WHITE’ FILLING PLACED 8 YEARS BEFORE
SANDWICH TECHNIQUE
?
NEW MATERIALS
RAMP CURING
INLAYS V OVERLAYS
INDIRECT COMPOSITE INLAYS
WHAT WENT WRONG??
COMPOSITE INLAYS
6 year old indirect inlay
WHY CUSPAL COVERAGE?
FAILING PORCELAIN INLAYS
INDIRECT GOLD INLAYS AND OVERLAYS
45 YEAR OLD SEMI-FIXED INLAY BRIDGE BRIDGE
33 year old gold overlays
PRESSED CERAMIC
INDIRECT PRESSED CERAMIC OVERLAY COVERING THE PALATAL BUT NOT THE BUCCAL CUSPS
2006 - e.max pressed
PRESSED CERAMIC
INITIALLY POOR COLOURS
RARE FRACTURE – 7 YEARS
LONGEVITY - 13 YEAR e.max
CONSERVATIVE PREPARATION
MARGINAL RIDGE PRESERVATION
13 year old IPS e.max
EMAX OVERLAYS TO AVOID POSTS IN ROOT TREATED PREMOLARS
ABSCESSES WHICH ARE NOT RELATED TO THE TOOTH APEX IN ROOT TREATED TEETH ARE GENERALLY INDICATIVE OF A ROOT FRACTURE
ROOT FRACTURE
OVERLAY PREPARATION SHAPES
JOIN
CEMENTATION
?
ZINC PHOSPHATE
POLYCARBOXYLATE
GLASS IONOMER
GOLD - RESIN MODIFIED GLASS IONOMER
e.Max - COMPOSITE RESIN LUTING CEMENTS • Conventional • Self adhesive • Self etch • Panavia
Conventional
Self adhesive
Self etch
FINISHING LINES
CHAMFER
SHOULDER
SHOULDER BEVEL
FEATHER