Аналіз варіантів формування каріозних порожнин I класу за Блеком під фотополімерні композиційні матеріали

Abstract

На ортопантомограмах проведено аналіз формування 123 каріозних порожнин І класу за Блеком у 86 хворих. За дизайном порожнин систематизовано їх 6 варіантів. Найчастіше в клініці препарують порожнини «ящикоподібної» (28,5 %), «безформної» (23,6 %), «куполоподібної» (21,1 %) та «блюдцеподібної» форми (19,5 %), рідше – «трапеціподібної» (4,9 %) і «кисетоподібної» (2,4 %). Наявність фальцу емалі, її нависаючих країв та характер кута між стінками і дном були різними в кожному варіанті, але в цілому нависаючий край емалі залишався у 13,0 %, сформований фальц емалі - 53,7 %, неокруглені кути - 18,0 % порожнин, що може погіршувати адаптацію фотополімерних композитів до тканин зуба.

На ортопантомограммах проведен анализ формирования 123 кариозных полостей І класса по Блеку у 86 больных. По дизайну полостей систематизированы их 6 вариантов. Чаще всего в клинике препарируют полости «ящиковидной» (28,5 %), «бесформной» (23,6 %), «куполообразной» (21,1 %) и «блюдцевидной» формы (19,5 %), реже – «трапецивидной» (4,9 %) и «кисетовидной» (2,4 %). Наличие фальца эмали, ее нависающих краев и характер угла между стенками и дном были различными в каждом варианте, но в целом нависающий край эмали оставался в 13,0 %, сформирован фальц эмали - 53,7 %, незакругленные углы - 18,0 % полостей, что может ухудшить адаптацию фотополимерных композитов к тканям зуба.

Final stage of caries, pulpitis and periodontitis treatment is cavity preparation, followed by restoration. Impermanence of restorations due to secondary decay is a social and medical problem, which consists in unreasonable patient’s and doctor’s time-consuming on repeated visits, strength reduction of dental hard tissues at next cavity preparation. Causes of secondary decay, except for physical and mechanical properties of restorative materials, and adhesive systems, can be peculiarities of carious cavity formation while preparing. Purpose of research - analysis of variants of carious cavities of I class by Black forming for light cure composite materials based on radiologic findings. Methods. Form of carious cavity of I class by Black, based on the orthopantomography of 86 patients, was studied in 123 molar upper and lower teeth, which were restored in uncomplicated caries with micro-hybrid photocomposite LATELUX (type II, ISO 4049:2000, manufacturer – privately held company “LATUS”, Ukraine). The period after dental restoration was 1.5—2 years. Analysis included design of carious cavity and their elements characteristics (floor, walls, corners, internal and external contours, enamel bevel). Results. We identified 6 variants of formed carious cavities. The 1st variant – rectangular cavities, “box-like”. This variant of cavity formation by dentists was the most common – 28.5%. The 2nd one – cavities without definite form, “formless”. They had irregular floor (occasionally multilayered), various incline of even and uneven walls and were found in 23.6 % of cases. The 3rd variant – cavities in the form of a dome, “dome-like”. They were recorded in 21.1 % of attendances. The 4th variant – carious cavities with flat even floor with divergent walls, “saucer-like” – in 2.4 % of examined samples. The 5th variant resembled the form of trapezium, “trapezium-like” cavities, which were found in 4.9 %. Carious cavities of the 6th variant were the rarest (2.4 %). They had oval floor, merging into walls of oval form, external contours of the cavity were smaller than internal and resembled pouch, “pouch-like”. Overhanging enamel edge without dentinal support was found in 17.1, 16.7 and 12.5 % of carious cavities of the 1st, 5th and 4th variants respectively. Overhanging edge in cavities of the 6th variant was in 100% of samples. This feature was rarer in cavities of the 2nd and 3rd variants - 6.9 % and 3.9 % respectively. Enamel fold was formed in 84.2% of cavities of the 3rd variant, 69.0 % - of the 2nd one, 62.5 % – of the 4th, 20.0 % – of the 1st and 3.3 % - of the 5th variant. Enamel bevel in cavities of the 6th variant was absent. Round corners were found in all carious cavities of the 5th and 6th type. Corners were graded in most cases of the 3rd and 1st variants – 92.3 % and 82.9 % respectively. Dentists rounded corners less often in carious cavities of the 2nd (75.9 %) and 4th type (70.8 %). Conclusions. While preparing carious cavities of the 1st class for light cure composite materials the technology of minimally invasive interventions and combination of minimally invasive with classical approaches is hold in clinical practice. Features of carious cavities formation of I class for composite restorations (absence of fold and overhanging enamel edges, rounded corners) are left out.