Jurado Carlos A, Fischer Nicholas G, Sayed Mohammed E, Villalobos-Tinoco Jose, Tsujimoto Akimasa
Prosthodontics, Woody L. Hunt School of Dental Medicine, Texas Tech University Health Sciences Center, El Paso, USA.
Minnesota Dental Research Center for Biomaterials and Biomechanics, School of Dentistry, University of Minnesota, Minneapolis, USA.
Cureus. 2021 Dec 27;13(12):e20748. doi: 10.7759/cureus.20748. eCollection 2021 Dec.
It has been well-documented that uncontaminated ground enamel provides the most predictable substrate for the bonding of ceramic veneers, and thus conservative tooth preparation with complete isolation using a rubber dam is key to the long-term success of the restorations presented with five years of follow-up. Rubber dam isolation provides several advantages to the clinician, such as preventing contamination of the working field by saliva, blood, and sulcular fluids, and improving direct visibility. However, it may be a challenge to the younger clinician to properly isolate teeth prior to bonding ceramic veneer. The present case report demonstrated the sequence and some clinical tips for a case in which the rubber dam is placed from a second premolar to the opposite second premolar and held with clamps, the rubber dam is gently invaginated into the sulcus, and clamps are selected and placed on each tooth to create an ideal situation for the adhesion of the ceramic veneer. This step-by-step sequence may help the younger clinician in understanding how to gently manage soft tissue in order to properly provide complete isolation with rubber dam for future bonding of ceramic veneers. Following these methods, the clinician can achieve complete isolation, invaginate the rubber dam in the sulcus without causing tissues to bleed, and reduce the time needed for bonding procedures.
有充分文献记载,未受污染的牙釉质为陶瓷贴面粘结提供了最可预测的基底,因此使用橡皮障进行完全隔离的保守性牙齿预备是随访五年的修复体长期成功的关键。橡皮障隔离为临床医生提供了几个优点,例如防止唾液、血液和龈沟液污染工作区域,并提高直接视野。然而,对于年轻的临床医生来说,在粘结陶瓷贴面之前正确隔离牙齿可能是一项挑战。本病例报告展示了从第二前磨牙到对侧第二前磨牙放置橡皮障并用夹子固定、将橡皮障轻轻压入龈沟以及为每颗牙齿选择并放置夹子以创造陶瓷贴面粘结理想条件的病例的操作顺序和一些临床技巧。这个循序渐进的顺序可能有助于年轻的临床医生理解如何轻柔地处理软组织,以便为未来陶瓷贴面的粘结正确地使用橡皮障进行完全隔离。遵循这些方法,临床医生可以实现完全隔离,将橡皮障压入龈沟而不导致组织出血,并减少粘结程序所需的时间。