| Abstract | Staklenoionomerni cementi imaju kemijsku adheziju za tvrda zubna tkiva, tolerantni su na prisutnost vlage, koeficijent termalne ekspanzije odgovara istome tvrdih zubnih tkiva, biokompatibilni su, bioaktivni te jednostavni za uporabu što im omogućuje široku primjenu u modernoj dentalnoj medicini. Mikrolaminirani SIC-i predstavljaju novu generaciju cemenata koji imaju poboljšana fizičko-mehanička svojstva te se mogu rabiti za izradu trajnih ispuna u stražnjoj regiji.
Nakon primjene lokalne anestezije za donji desni prvi kutnjak, karijesna lezija je otvorena okruglim dijamantnim svrdlom uz vodeno hlađenje. Zub je izoliran gumenom plahticom, a za uklanjanje karijesne lezije, odabran je modificirani atraumatski tretman (ARTm). Okruglim čeličnim svrdlom, bez vodenog hlađenja, uklonjena je karijesna lezija u području caklinsko – dentinskog spojišta, a parapulpno je karijesni dentin uklonjen ručnim instrumentima. Nakon kondiciniranja kaviteta 10%-tnom poliakrilnom kiselinom (Dentin conditioner, GC, Tokio, Japan) kroz 20 sekundi, ispiranja vodom i sušenja sterilnom vaticom, kavitet je zatvoren kapsuliranim SIC-om EQUIA Forte Fil (GC, Tokio, Japan). Nakon usklađivanja okluzije i artikulacije, na površinu je nanesen premaz EQUIA Forte Coat (GC, Tokio, Japan) koji je osvijetljen LED polimerizacijskom lampom.
U opisanom prikazu slučaja, kod pacijenta s visokim rizikom od nastanka karijesa i uznapredovalom karijesnom lezijom na donjem desnom prvom kutnjaku, modificiranim ART-om uklonjen je vanjski, inficirani dio karijesne lezije kako se ne bi ugrozio vitalitet pulpe. Zatim je na unutrašnji, demineralizirani dentin postavljen trajni ispun od mikrolaminiranog SIC-a zbog svojstva bioaktivnosti materijala i mogućnosti interne remineralizalizacije demineraliziranog dentina. Na kontrolnom pregledu nakon 6 mjeseci zub je asimptomatski, a ispun zadovoljava estetske, funkcionalne i biološke zahtjeve. |
| Abstract (english) | Glass ionomer cements have chemical bonding to hard dental tissues, they are moisture tolerant, coefficient of thermal expansion is similar to hard dental tissues coefficient, they are biocompatible, bioactive and simple for use, which allows them to be widely used in modern dental medicine. Microlaminated GICs represent a new generation of cements that have improved physico-mechanical properties and can be used as permanent fillings in the posterior region.
After applying local anesthesia for the lower right first molar, caries lesion was opened with a round diamond drill with water cooling, the tooth was isolated with a rubber dam, and the modified atraumatic treatment (ARTm) was performed for the removal of caries lesion. Carious tissue at dentin-enamel junction was removed with round steel burs, without water cooling and, on the parapulpal wall, carious dentin was removed with hand instruments. After conditioning the cavity with 10% polyacrylic acid (Dentin conditioner, GC, Tokyo, Japan) for 20 seconds, rinsing the cavity with water and drying it with sterile cotton pellet, the cavity was filled with capsulated GIC EQUIA Forte Fil (GC, Tokyo, Japan). After checking occlusion and articulation, the surface was coated with EQUIA Forte Coat (GC, Tokyo, Japan), which was light-cured with a LED polymerization lamp.
In this clinical case, in a patient with high caries risk and advanced caries lesion on the lower right first molar, the external infected layer of caries lesion was removed using modified ART, in order to preserve the vitality of the pulp. On the inner layer of demineralized dentin, due to the bioactivity of the material and the ability for internal remineralisation, a permanent filling of the microlaminated GIC was placed. At follow-up visit after 6 months, the tooth is asymptomatic and the filling fulfills the aesthetic, functional and biological requirements. |
