Thank you for the presentation, I have couple of questions. first what are the differences between covering the dentine with resin then cemented the inlay using resin?? don't u think that this increase the interface between the cements giving the fact that u contaminate the first layer of resin when u place it and then took impression. second question how did u know that the medial crack on the distal wall are partial and stabilized??? can u confirm that there are no microcrack created and it might at anytime extend more since it will be under occlusal force and will leak in future and leads to caries??? all respect.
Thank you for your questions . Using the IDS technique (immediate dentin sealing) you protect dentin from contamination and more important, you have two similar materials to lute using composite as luting material (composite over composite and enamel) avoiding the sensitive part of the procedure (dentine luting to composite). The procedure is analyzed in details in the video The contaminated composite surface is sand-blasted and with acid cleanup before the luting procedure. So we are sure that the surface is modified and very clean before luting (also in the video).The crack is crack, not fracture, we see it perfectly, so it is partial and it is stabilized perfectly after luting because it is connected adhesivelly with the inlay material and thus reinforced. That is the magic of adhesive dentistry! There is no crack extension in the future, I assure you.
Thank you for oyur valuable presentation. If possible I have a few questions.. What kind of material (Lava, full ceramic, feldspatic or ...) and system (cerec?) do you use? Which warmer (Calset?) do you use? And the composite universal or posterior? Do you use any silanisation if you perfprm the cementation 1 week after first appointment? Thanks.
1.The material was Lab composite Shofu Solidex made by hand, not CAD/CAM. 2. Yes we use Calset 3. The luting composite was universal. We use posterior composite (bulk) now, Kerr Sonicfill. 4. Yes we use silane (see video 8 min 10 sec)
the use of pre-heated composite vs resin cements. i understand what you said about the vantage of being only 1 interface, but in recent studies they said that the resin will start to cool and the interface its like the double of the interface when used resin cement, witch downs the resistance, so there's no clinical difference. i also heard about cementation with flow. what do you thing? thanks! ps - sorry for any mistakes, i'm portuguese!
Is the luting composite light-cure only？ why not dural-cured? How can you ensure it is fully polymerized ? where can i found resin heater, what degree should i heat it ?
Yes it is light-cure composite. You can use dual-cure if you wish, but light-cure has better properties. You can be sure about proper polymerization if you use a modern powerful LED lamp (over 1000 mW/cm2) and extend the polymerization time to one minute from every surface. Following the Links you will find the two well known heaters. The degree is between 50-65 Celsius. optident.co.uk/product/ena-heat-composite-heating-conditioner/ addent-store.myshopify.com/products/calset-composite-heater-p-n-110007-with-power-supply-composite-compule-tray
+Emmanuel Kassotakis thank you doctor :) i have another question, is this method better than direct composite restoration? and why? and which luting cement do you use? and do you use normal composite for the indirect method? sorry if i ask too much iam new doctor but i'd love to start doing indirect restoration instead of prep+crown because i think the tooth will live longer this way :)
+Samed Jabali 1. Yes this is a better method because you have much better anatomy (occlusal and proximal), better aesthetics, better physical properties and polymerization shrinkage absence. 2. Generally we use normal warm restorative composite for luting. Some times, when the indirect restoration fits perfectly, we use normal flowable composites. 3. The composites for indirect restorations are "special" lab composites (most companies have those) and the in lab polymerization procedure gives us much better results regarding the polymerization percentage. But you can use a normal highly filled "office" composite as well.
There are not caries, it is just stains. The medial fracture is partial and very well stabilized after the adhesion procedure. Thanks for the question.
+ellasjellybean If the restoration has a perfect fitting, yes, you can use flowable composite. If the fitting is not so accurate you must use preheated conventional, not packable composite, it is much better. The only packable composite appropriate for luting indirect composite restorations is the SonicFill by Kerr, due to its viscosity properties (preheated is similar to flowable).
