PROCEDURE FOR LUTING OF CERAMIC TO TOOTH STRUCTURE

 Surface conditioning of ceramic using
 hydroflouric acid gel
 or air abrasion .

 Aplication of silane coupling agent . ex :  MONOBOND S  ( ivoclar , germany )

  Followed by the application of resin luting cement .  ex : rely x unicem , clearfil se etc

REVITILISATION OF NON VITAL TOOTH USING PLATELET RICH PLASMA ( PRP )

Initially the tooth to be treated should be administrated with local anesthesia access cavity is prepared. On entry into the root canal. The necrotic pulp should be removed with the aid of a large barbed broach. The working length was determined using an apex locator EX : Elements,sybron endo.) . The canal should be irrigated with approximately 10 ml of 5.25% NaOC1 and dried with paper points. Equal proportions of ciprofloxacin, metronidazole, and minocycine should be ground and mixed with distilled water to a thick paste consistency. This antibiotic mixture should be than placed in the canal using an amalgam carrier and packed with large endodontic pluggers. After which the access cavity was sealed with Cavit ( 3M,ESPE,  France).

A 20-ml sample of whole blood should be drawn from the patient’s right arm for platelet rich plasma (PRP) preparation. PRP is prepared by mixing SmartPReP2 APC+ Autologous Platelet Concentrate+ Procedure Pack (Harvest Technologies Corp, Plymouth, MA) with the Harvest SmartPREP 2 Platelet Concentrate System (Harvest Technologies Corp).

During the next appointment, the teeth should be isolated with a rubber dam, the temporary restoration should be removed, and the antibiotic mixture was washed out by using sterile saline irrigation. The canal was dried with paper points. Prepared PRP should be then injected into the canal space up to the level of the cemento -enamel junction (CEJ) and allowed to clot for 5 minutes. 3mm of white MTA (Pro- Root MTA; Dentsply )was placed directly over the PRP clot. A moist cotton pellet was placed over the MTA and finally restored with GIC ( GC corp,japan.).

                                                REF:JOE,37,2011.

SILICONE BASED SEALER .(ROEKO SEAL)

It is a silicone based sealer.

It consists of polydimethyl siloxane, silicon oil, paraffin-base oil, hexachloroplatinic acid (catalyst) zirconium dioxide.

It is supplied in a dual tube syringe which is ready to use.

It has excellent biocompatibility.

Less  microleakage.

.

REF: J.ORAL.REHAB,2003

SOLVENTS FOR DISSOLVING GUTTA PERCHA

1. eucalyptol
2. xylene/xylol
3.  methyl chloroform
4. tetrahydrofuran
5. methylene chloride
6.  halothane
7.  rectified turpentine  and
8.  orange solvent

REF: Endodontic Topics 2011, 19, 33–57

TECHNIQUE FOR FABRICATION OF CUSTOM MADE POST WITH METAL POST AND CERAMIC CORE

Post space preparation should be completed first. Make a keyway at the coronal end of the root canal to provide adequate metal and ceramic thickness.

Select an appropriate size prefabricated plastic burnout post pattern to the prepared root canal and leave an extension for the retention of ceramic core. After lubrication of the root canal, reline the plastic post with a self curing acrylic resin material to ensure an optimal adaptation to the canal.

Finish line should be a rounded shoulder, which will provide adequate ceramic thickness.

Cast the post using a porcelain metal alloy and coat the core extension with opaque ceramic to mask the metal.

Verify the fit of the post in the canal and build up the core with self curing acrylic resin. Once the resin has polymerized, prepare the core pattern in the usual manner for an all-ceramic crown .

Remove and invest the resin core with the cast metal post. After the burnout and preheating process, heat-press the core from leucite reinforced glass-ceramic (ex : IPS impress , ivoclar , germany ) with the desired shade

After verifying the fit, cement the metal post and ceramic core assembly using a self-curing resin cement. The post-and-core is ready to undergo impression for the all-ceramic crown.

Finally cement the finished all-ceramic crown to the core.

REF : Dental Traurnatology ,21, 2005.

HORIZONTAL ROOT FRACTURE ( MANAGEMENT- intra -radicular splinting )

.

First root canal treatment should be initiated. A no. 15 K file should be passed through the fracture and the apical root segment should be accessed.  Then the fractured tooth should be fixed rigidly using a dentin-bonded composite resin (EX : Filtek Z250, 3M ESPE.),with the adjacent teeth.The root canal should be cleaned, shaped and enlarged to a size of file 70,and the canal should be filled temporarily for 3 months with calcium hydroxide paste.

After three months, the dressing should be carefully removed from the canal, and the canal was enlarged to no. 110 K file size. Any resin root canal sealer (EX : AH PLUS Dentsply, Germany) should be introduced into the canal using a K file. Zinc polycarboxylate cement should be mixed and placed in the canal with a lentulo spiral carefully and then a no. 110 K file should be coated with polycarboxylate cement and fixed in the canal. After the polycarboxylate cement set, the hand part of the K file should be cut away using diamond round burs on a high-speed air turbine with water-cooling. The endodontic access cavity should be then  filled with the dentin-bonded composite resin.

REF : Dental Traurnatologv ,24,2008.

VENEERS ( CLASSIFICATION )

Veneers can be basically classified in to two types

1. partial veneers
2. full veneers.

Partial veneers are indicated for the restoration of localized defects or areas of intrinsic discoloration .

 Full veneers are indicated for the restoration of generalized defects or areas of intrinsic staining involving the majority of the facial surface of the tooth.

Full veneers can be further subdivided in to two types based on tooth preparation.

1. Full veneer with window preparation design that extends to gingival crest and terminates at the facioincisal angle.  

2. Full veneer with i ncisal-lapping preparation design extending subgingivally that includes all of incisal surface.

Full veneers can be accomplished by a direct or an indirect technique.

REF: ART AND SCIENCE OF OPERATIVE DENTISTRY -STURDEVENT