One of the important problems of dentistry is the achievement of long-term and aesthetic restoration in the treatment of dental caries and its complications, traumatic dental injuries in children.
The aim of the study was to evaluate the effectiveness of the application of the microhybrid photopolymerizable composite enamel for restorations of various groups of permanent teeth with a high degree of destruction.
Material and methods. The study involved 76 patients aged 7-17 years of teeth, who were treated with 147 permanent teeth using the restoration material enamel (Enamel plus HFO / Micerium, Italy). Enamel is a restoration system that includes materials of five types (dentines, basic enamels, opalescent enamels, intense enamels and paints), the use of which allows you to reproduce the five main characteristics that make up the color of natural teeth. The chromaticity of the color is provided by seven universal fluorescent dentines (UD1-UD6), which perfectly react to light, repeating the same properties of a natural tooth. The brightness of the color is created by three basic enamels (GE1-GE3) of low, medium and high brightness.
The translucency and brightness of the enamel, created by dentines and basic enamels, are calibrated in accordance with the characteristics of natural enamel, which are inherent in different age groups of patients. Intensity (intensives) of color and its personalization is achieved with the help of two intensive enamels: IM-Intensive Milky creates a warm and saturated shade of white, intense white (IW-Intensive White) — a cool shade of white. Opalescence of color is achieved by using a universal opalescent natural blue enamel (OBN — Opalescent Blue Natural).
Special characteristics of restorations, intensification of saturation, brightness, intensity, as well as internal incisal opalescence, are created with the help of additional opalescent enamels: white (OW-Opalescent White), amber (OA-Opalescent Amber) and gray (OG-Opalescent Gray). Fluorescent paints (white, yellow, orange, blue, brown and dark brown) are designed to reproduce fine tooth structures, internal shades, fissures, spots, cracks and other individual characteristics, for the same purpose can also be used OW, IW, IM and OA. To create a natural shine of the tooth, a connecting layer (Glass connector) is designed, which is superimposed between the dentins and enamels, excluding the marginal regions of the restoration.
The restoration process included the following stages: professional oral hygiene, anesthesia, preparation of the carious cavity, grinding and polishing the edges of the enamel, applying a curative and / or insulating pad (as indicated), etching, acid washing, drying, application and polymerization of the adhesive system, and polymerization of the material in accordance with the thickness of the layers and the time of illumination in accordance with the manufacturer’s instructions, grinding and polishing the restoration. Repeated examinations were carried out at 6, 12, 24, 36 months (the study period was 3 years).
To assess the state of restorations during repeated examinations, the Ryge classification was used, taking into account the following criteria: anatomical shape, marginal fit, color of restoration, appearance of secondary caries. The excellent rating (Alfa — A) reflected the presence of a restoration that completely retained all the main characteristics, and the absence of secondary caries. A satisfactory rating (Bravo-B) characterized the presence of small changes, easily correctable without replacement of the restoration. Unsatisfactory assessments: Charlie (C) — showed significant abnormalities in the anatomical shape, marginal fit, colors requiring replacement of the restoration, Delta (D) — changes (deposition of the filling, secondary caries, etc.) that require repeated tooth treatment.
Results of the study. Immediately after the imposition, 100% of the restorations were rated «A» by all criteria, in 6 months 98.6% — had excellent results by all criteria, 1.4% — a satisfactory «B» rating by one criterion. After 12 months, 93.2% of the restorations had an «A» rating according to all criteria, a 6.8% «B» rating according to two or more criteria.
After 24 and 36 months, 87.8% and 85.7% of restorations received excellent results, 10.9% and 11.6% of restorations were satisfactory, and only 1.3% and 2.7% of restorations, respectively, were unsatisfactory assessment of «C», «D» estimates were not. Working with the enamel material required the development of the skill of selecting the color gamut of the constituent layers, which was helped by the drawing up of a preliminary color map of the restoration, as well as the acquisition of clinical experience in the process of working with the material.
The conclusion. High efficiency, strength, functionality and aesthetics, identified after 36 months in most enamel restorations, allow us to recommend its use in children in the treatment
Сообщение Experience in the use of restorative material enamel in the practice of pediatric dentistry « появились сначала на Имплантация зубов.