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Mercury,Esthetics !!!

Amalgam
Fillers, Shrinkage !!!

Composite
Fluoride release,adhesion
vs Wear !!!

GIC
Wilson 1970
Glass Ionomer
Cement
SANDWICH TECHNIQUE

CONBINES THE ADVANTAGES OF BOTH GLASS


IONOMER CEMENTS AND COMPOSITE
RESTORATIONS

i.e. BONDING TO DENTIN, FLUORIDE RELEASE


AND NO POLYMERIZATION SHRINKAGE + BETTER
ESTHETICS,
BONDING TO ENAMEL AND BETTER WEAR
RESISTANCE.
Resin reinforced GIC
Resin modified glass ionomers

They contain the same


components as traditional
GICs, but have a resin
material added to provide
strength
Resin modified glass ionomers

Two component system


• Initiators
• Acid base reaction
Compomers
Compomers

Poly acid modified resins


They are essentially resin composites
where the resin monomer is modified
to contain acidic functional groups
capable of participating in an acid
base reaction after the polymerization
of the resin molecule has taken place
Compomers

Single component system,


where resin polymerization
takes place after curing
then a glass ionomer
reaction takes place in the
presence of saliva.
Amalgam

Composite
Compomers

GIC

Resin reinforced GIC


Caries risk
assessment

Risk factors and indicators


A complete series of
final restorations should
not be placed for a
patient in whom there is
still active disease
Caries activity testing
To predict cariogenic potential

They are most useful for


patient motivation and for
monitoring patient’s progress
after proper oral hygiene
levels have been attained
Lactobacilli are more related to
misuse of CHO, while high
numbers of S. mutans will
reflect the patient’s difficulty in
maintaining oral hygiene.
Lactobacilli are not sensitive to
chlorhexidine

DeSoet, Dental Update,1998


Modified Snyder test

It is a colorametric test
that measures the amount
of acid formed in a
carbohydrate medium by
micro organisms in saliva
(acidogenic potential)
Bromcresol green
Blue green acid Yellow

pH 4.7 - 5

pH 4.2 – 4.6

pH < 4

positive
Modified
Snyder
Caries activity test

24 h 48 h 72 h
marked + ve
Moderate - ve + ve

slight - ve - ve +ve
- ve - ve - ve - ve
Caries detecting Dye
1% acid red solution
in propylene glycol

Bonds to denaturated
collagen
Air abrasion
Aluminum Oxide Particles
• Isolation & drying.
• Application of C.D.
• After 10 sec, wash.
• Remove stained tissue.
• Repeat staining.
art
Atraumatic Restorative
Treatment

Alternative restorative
treatment
Frencken etal, J Public Health Dent
1996 & Caries Res, 1998
Phantumvanit etal, J Public Health
Dent 1996
ART requires no electric driven
equipment using hand instruments,
GIC and finger press reported
85.3% & 77%survival.
The outline of the cavity
preparation and dentinoenamel
junction should be free of caries.
Frencken 1994

Fuji IX is better
than Fuji III

ART

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