kompoziciuri vinirebiT frontalur kbilTa restavracia

 

dea vadaWkoria  med. mecn. kandidati

 

Tbilisis saxelmwifo samedicino universitetis Terapiuli stomatologiis kaTedra

stomatologiisa da samedicino esTetikis  qarTul- germanul- espanuri klinika “unident – rosi”

 

     frontalur kbilTa restavrireba kbilTa kariesiT, travmiT, arakariesuli warmoSobis dazianebebiT, cveTiT an maTi diskolorizaciiTaa pirobadebuli. xSirad kbilis gvirgvinTa dazianebebs kombinirebuli xasiaTi aqvs.(1,2) zemoaRniSnuls emateba diasTemebiTa da tremebiT gamowveuli esTetikuri uxerxuloba da pacientTa survili, moxdes maTi drouli da efeqturi koreqcia. aRniSnuli problemebis gadaWra konservatiul stomatologiaSi kompoziciuri vinirebiTaa SesaZlebeli. vinirebi, erTis mxriv, saSualebas iZlevian restavraciis procesSi gauqmdes sazRvari sarestavracio masalebsa da kbilis magar qsovilebs Soris, rac did uxerxulobas uqmnis pacients da zrdis meoradi kariesis ganviTarebis risks.(3) meores mxriv, kompoziciuri vinirebiT SesaZlebeli xdeba orTopediuli konstruqciebis gareSe ganxorcieldes zogierT kbilTa dgomis, formis da feris koreqcia.

 srulyofili vinirebisaTvis mravali faqtoris gaTvaliswinebaa saWiro, rac dazianebaTa zust diagnostirebas, preparirebas, sarestavracio saSualebaTa SerCevas da vinirebis zustad Catarebas moicavs. winaaRmdeg SemTxvevaSi restavraciis Semdgom garTulebaTa sixSire da simZime aramxolod SebRalavs restavrirebis xarisxs, aramed uaryofiTad imoqmedebs umTavres principze _ eqimsa da pacients Soris damokidebulebis fenomenze. swored aman gansazRvra Cveni kvlevis mizani..

frontalur kbilTa kompoziciuri vinirebiT aRdgenis meTodTa daxveYwa da postrestavraciul garTulebaTa Tavidan acilebis gzebis SemuSaveba.

      Cveni kvlevis procesSi sul CavatareT 158 restavracia. maT Soris 59 viniriT restavrirebul kbils pulpis cxovelmyofeloba SenarCunebuli hqonda. maTgan 24 SemTxvevaSi vinirTa damzadebis Cvenebas araesTetikurad restavrirebuli V klasis kariesuli defeqtebi warmoadgenda. 15 SemTxvevaSi frontalur kbilebze aRiniSna minanqris hipoplazia. 10 kbilze aRvwereT blekiT III, IV da V klasis kariesul defeqtTa SeuRlebuli kombinacia. 6 SemTxvevaSi soliseburi defeqti da 4 SemTxvevaSi pirdapiri kompoziciuri vinirebiT daixura diasTema. 99 kbilze  vinirebiT restavrirebis Cvenebas ZiriTadad kbilTa diskolorizacia warmoadgenda. maTgan 45 SemTxvevaSi kbilebze adre ukve Catarebuli iyo endodontiuri mkurnaloba, magram kbilis gvirgvinze aRiniSneboda ramdenime restavrirebuli kariesuli defeqti. 29 SemTxvevaSi endodontiuri mkurnaloba Catarebuli iyo, magram kbilTa gvirgvinebis vestibuluri zedapiri dauzianebeli iyo. 25 SemTxvevaSi endodontiuri mkurnaloba Catarebuli iyo travmis Sedegad gvirgvinis dazianebis gamo.

restavrirebis procesSi frontalur kbilTa pirdapiri kompoziciuri vinireba 2 meTodiT ganvaxorcieleT. subopakeris teqnikis gamoyenebiT da orjerpolimerizebuli kompoziciuri vinirebiT. pirveli meTodiT 81 restavracia Catarda, meore meTodiT ki _ 77.

kvlevis procesSi gansakuTrebul yuradRebas frontalur kbilTa gvirgvinebis preparirebis zogierT Taviseburebas vuTmobdiT. preparirebis diapazoni ar SeiZleba iyos ganusazRvreli, magram sxvadasxva avtors e. w. “asaRebi” minanqris sxvadasxva sisqe aqvs mowodebuli .(4,5)

Cveni kvlevis procesSi, gansakuTrebiT ki maSin, rodesac saqme diskolorizebul kbilebs exeboda, preparirebis Semdegi siRrme avirCieT: 1,5-1-1 mm. xolo vitaluri kbilebis SemTxvevaSi 1-1-1 mm. am gziT vaformirebdiT sakmao siRrmis sarestavracio sarecels, romelSic Tavisuflad Tavsdeboda kompoziciuri vinirebi Tavisi Semadgeneli SreebiT.

 gansakuTrebiT sagulisxmoa, kbilTa vinirebis procesSi akriluri matricebis gamoyenebis aqtualoba. maTi gamoyenebiT aRdgenil kbils hqonda mezobeli kbilis minanqris magvari reliefi da sikriale.

aRsaniSnavia, subopakeris da orjerpolimerizebuli kompoziciuri vinirebiT restavrirebisas   “sendviC” meTodis Catarebis Taviseburebebi, rac orive vinirebis damzadebis safuZveli iyo. es teqnika kbilis preparirebul zedapirze jer mikrohibriduli Txeli Sris moTavsebas gulisxmobs da mxolod Semdeg kompomeris, ormokeris an hibridis opakeris. Cveni kvlevis procesSi, emalis formirebul sarecelze pirvel Sred vaTavsebdiT an Herculaite-is opakers an Revolution-Flow-s. pirveli Sris Semdeg vestibulur zedapirze vaTavsebdiT e. w. subopakeris Sres. am mizniT gamoviyeneT Dentsply-s Dyrect da Voco-s Admiva.  subopakeris Sres Cvenebis mixedviT zevidan vfaravdiT saboloo hibriduli kompozitis mimanqris feniT an, Tu restavrireba saSualebas iZleoda, minanqrisa da dentinis ferebiT. swored am bolo Sreebis sxivur gamyarebamde vaTavsebdiT masze akrilur matricas da vinirs vaZlevdiT saboloo formas.

    kvlevis procesSi gamoviyeneT erTkomponentiani adheziuri sistemebi - Ultradent-is PQ-1 da Morita-s AQ-bond-i. pirdapiri kompoziciuri vinirebiT frontalur kbilTa restavrirebis xarisxis klinikuri SefasebisaTvis movaxdineT restavrirebul kbilis midamoSi 1)kbil-RrZilovani siTxis Seswavla 2)kbil-RrZilovani napralis siRrmis gansazRvra 3) RrZilis kidis retraqciisa da hiperplaziis maCvenebelTa cvlilebebis dadgena 4)RrZilis kidis sisxldenis xarisxis dadgena 5)kompoziciur vinirsa da kbilis magar qsovilTa mikavSirebis xarisxis gansazRvra da 6) vitalur kbilTa hiperesTeziis intensivobis gansazRvra. sabolood ki, rodesac restavrirebis xarisxs vafasebdiT, yuradRebas vamaxvilebdiT Semdeg faqtorebze: a)restavraciis mTlianobis darRveva b)meoradi recidivuli kariesis aRmoCena g)vitalur kbilTa hiperesTezia. am niSandobliv faqtrebze dayrdnobiT restavracias miviCnevdiT kargad, damakamyofileblad an aradamakmayofileblad.

         sabolood, minda aRvniSno, rom pirdapiri kompoziciuri vinirebiT kbilTa aRdgenis meTodis SerCeva eqimis gadasawyvetia, magram restavrirebis procesSi unda gaviTvaliswinoT yvela is SesaZlo garTuleba, naklovani mxare Tu xarvezi, rac restavrirebis Semdgom SeiZleba gamoCndes. es procesi xSirad gardauvalia da yovelTvis eqimis kvalifikaciaze rodia damokidebuli, magram mkurnalis profesionalizmic swored imaSi mdgomareobs, Tu am garTulebaTa droul diagnostirebas da warmatebiT aRmofxvras SeZlebs.

 

                             

 

 

 

 

literatura:

 

  1. Cheek C.C., Heymann H.O. – Dental and oral discoloration associated with minocycline and other tetracycline analogs. // J. Esth. Dent., 1999, v.11., N1, p.43-48.
  2. Magne P., et al. – Crack propensity of porcelain laminate veneers. // J. Prosthet. Dent., 1999, v.81, N3, p.324–334.
  3. Terry D. -  Direct reconstruction of the maxillary anterior dentition with composite resin: a case report. // Pract. Periodontics Aesthet. Dent., 1999, v.11, N3, p.361 –367.
  4. Dietchi D., Spreafico R. – Tooth preparation. // Adhesive Metal – Free Restorations., 1997, ch.3, p.35-60.
  5. Fahl N., Denehy G.E., Jackson R.D., - Protocol for predictable restoration of anterior teeth with composite resins. // Pract. Periodont. Aesthet. Dent., 1995, v.7, N8, p.13-21.

 

 

 

Frontal Teeth Restoration with Composite Veneers

Dea Vadachkoria  M.D., Ph.D.

 

Conservative Dentistry Department of Tbilisi State Medical University

 

Georgian – German – Spanish Dental and Medical Aesthetic Clinic

“UniDent- ROS’S”

 

Summary

 

The patient’s demand for treatment of unaesthetic anterior teeth is steadily growing.  Accordingly, several treatment options have been proposed to restore the aesthetic appearance of the dentition. For many years, the most predictable and durable aesthetic correction of anterior teeth has been achieved by the preparation of full crowns. However, this approach is undoubtedly most invasive with substantial removal of large amounts of sound tooth substance and possible adverse effects on adjacent pulp and periodontal tissues.  

 In search for more durable aesthetic, porcelain laminate veneers have been introduced during the last decade. But however restorations made by direct composite veneers remained to be actual.

 The purpose of our research was to improve the frontal teeth veneering process with direct composite veneers   made by two different methods: direct composite veneers made by subopaue technique and direct composite veneers made by double polymerization.

 The choice, which method of direct composite veneer is advisable to use, is completely dentist’s right. But, however, during restoration we should take under consideration all possible difficulties, adverse effects and fails, which might be evident after completing the restoration. This process is often unpredictable and it doesn’t necessarily depend on dentist skills, but clinician’s professionalism and intelligence is absolutely obvious, if he/she could diagnose on time all above mentioned adverse effects and will be able to eliminate them.