A dental orthopedist of the Dental Center “Mikros” Zakharchuk Vasyl Mykolaiovych in association with his colleagues have an honor to publish an article «FIBRE COMPOSITE» - IT’S EASY!» in the authorized dental journal “ Denta Club” and offer his mite in Ukrainian modern dentistry development. The submitted article traces the acute problems in orthopedic dentistry and efficient ways of their decision to the patient and the dentist.
of the Dental Center “Mikros”
“FIBRE COMPOSITE” – IT’S EASY! It is a technique of demountable photopolymer stump inlay with fiber glass posts “FIBRE COMPOSITE”
A dentist on specialty orthopedic rehabilitation at his work frequently encounters with situations demanding on the full restoration of a coronal part of teeth adjusted a stump. The prosthesis of broken off and obliterated teeth remain some complications. Mostly the choice is fixed upon the stump which is to be justified. But exceptions often happened. What to do with multi-rooted teeth having some angulated root canal ramifications. How to make and fix inlays with nonparallel rami. There is also some other less pleasant moments such as strip perforations under root preparation for cast stump inlays. An additional work such as demount of the cast stump inlay to separate parts with the further extraction at the repeating endodontic penetration is also required. It makes treatment planning complicated.
Due to the abovementioned facts, our team decided to reconsider the rooted stereotypes and gave the life to a new idea, which, probably, become a choice for the most dental technicians. We submit you the protocol of producing demountable photopolymer the cast stump inlay with glass fiber posts – “FIBRE COMPOSITE”. Our team prefers to use in its work far-famed in UKRAINE Italian products of the company DEI: armor composites Clever Fibre Composite, glass-fiber posts Anatomic Glass, isolative silicone DEI Isofilm.
To make demountable photopolymer cast stump inlay the classical technique of cavity preparation with parallel wall formation is used, where the root canals are developed by Gates Glidden of certain sizes and lengths depending on the anatomical position of the tooth and chosen beforehand sizes of the posts. In cavity formation, we have to prepare inner edge which is the beginning of the modeling of the artificial stump of the teeth. Following these rules, the stump will physiologically transfer loading to the root system. After that, the impression of silicon mass is taken and brought to the lab.
Picture 1. The tooth N26 has been pulpless for 6 years. After the old restoration and caries tissue removal, it has been decided to make a dismountable stump inlay.
Picture 2. The first stage: the mold is isolated with silicone DEI Isofilm.
Picture 3. After that, the posts are isolated with thin wax layer to form the even shell. The wax allows demounting the construction and makes some space for flowing cement down needed for fixation.
Picture 4. Anatomical Glass Posts.
Picture 5. Place the posts on the mold; make the form of the stump inlay, 3 minutes polymerization.
Picture 6-7. After polymerization, gypsum mold with the construction put into boiling water to remove wax from the posts. Demount the construction; remove the glass-fiber posts and the stump.
Picture 8. The prepared construction FIBRE COMPOSITE consists of two parts: the post and the stump. Demountable construction is polymerizing again to get full material conversion. With the help of the steam-ejecting device, the rest of wax is removed from the construction.
Picture 10-11. The inlay is ready for the use in the clinic. The doctor fits it in the oral cavity with the further cementation directed by the protocol of adhesive fixation.
Picture 12-13. The stump is prepared for a crown, 90 edge.
Picture 14-15. The final result. The composite crown is pressed in clear muffle according to the technique Paulo Pagliari MCM (Monolithic Composite Method).
Advantages of the demountable stump inlay “FIBRE COMPOSITE”
In comparison with metal CSI (cast stump inlay):
Shock Absorption. The composite takes some bite force (the metal does not do it), thus, the tooth and periodontium are less traumatized.
Elasticity. The elasticity of glass fiber posts is similar to natural dentine. We use it to prevent fracture of the tooth root under the high loading.
Color. It is possible to receive more acceptable color in comparison with metal cast inlay.
Time. This technique is easy to apply. It requires less time in comparison with a metal cast stump inlay, excluded expenditures for casting. The risk of perforation and tooth cracked syndrome is reduced because there is no necessity in cervical and root dentine preparation, as well as in parallel canals.
In comparison with direct restoration technique: time saving of the dentist, comfort for the patient, it takes less time for the preparing of the oral cavity.
We are not the first to suggest applying of demountable constructions. There are other protocols submitted demountable stump inlays descriptions. But from the technical point of view, it is the rather complicated process. We seem that Fibre composite is worth of practitioner’s attention and estimated for its advantages.
And finally, the work has turned to be more efficient with FIBRE COMPOSITE. And some more tips to draw your attention. Using the FIBRE COMPOSITE materials at our practice, we noticed that the work goes faster when the simplest glass-fiber posts of cylindrical cross shape, without additional retention grooves denying construction positioning, are used.
Questions concerning the complicated structural positioning can be solved by making guiding grooving at the tooth preparation stage for the inlay FIBRE COMPOSITE.
Enjoy your work, colleagues.