Yu Ollie Yiru, Zaeneldin Ahmed Mohamed, Hamama Hamdi Hosni Hamda, Mei May Lei, Patel Neil, Chu Chun-Hung
Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, People's Republic of China.
Faculty of Dentistry, Mansoura University, Mansoura, Dakahlia, Egypt.
Clin Cosmet Investig Dent. 2020 Oct 8;12:415-422. doi: 10.2147/CCIDE.S270453. eCollection 2020.
The paradigms of contemporary caries management have shifted to minimal intervention dentistry. Conservative restorative procedures are recommended to replace the complete removal of all carious tissues in the management of dental caries. This article reports two clinical cases of conservative restorations of proximal caries. Different conservative cavity designs and restorative techniques were performed in the two cases. Proximal caries in posterior teeth were prepared using the box-only preparation technique or the proximal tunnel preparation technique. The cavities were restored directly with resin composites. The advantages of using the box-only preparation with fissure sealant included the maximum conservation of tooth hard tissues and the prevention of unnecessary tissue removal in the occlusal surface. The tunnel preparation preserved the marginal ridge and protected the restored tooth from fracture. The filling of composites into the tunnel demonstrated a better marginal adaptation than other restorative materials. These two techniques allowed for the preservation of more healthy dental hard tissue compared with traditional techniques. Potential problems in the restoration included the high incidence of the inappropriate removal of dental hard tissue, damage of the vital pulp and the microleakage due to the polymerization shrinkage. The solutions to minimize the risk of these problems in the operative procedures were discussed.
当代龋病管理模式已转向微创牙科。在龋病管理中,建议采用保守性修复程序来替代完全去除所有龋坏组织的方法。本文报告了两例邻面龋保守修复的临床病例。两例采用了不同的保守洞型设计和修复技术。后牙邻面龋采用仅制备盒状洞型技术或邻面隧道制备技术进行制备。窝洞直接用树脂复合材料修复。仅制备盒状洞型并使用窝沟封闭剂的优点包括最大限度地保留牙齿硬组织以及防止在咬合面不必要地去除组织。隧道制备保留了边缘嵴,并保护修复后的牙齿不发生折断。将复合材料填入隧道显示出比其他修复材料更好的边缘适应性。与传统技术相比,这两种技术能保留更多健康的牙齿硬组织。修复中的潜在问题包括不适当去除牙齿硬组织的发生率高、牙髓损伤以及聚合收缩导致的微渗漏。文中讨论了在手术操作中尽量降低这些问题风险的解决方法。