[Keyword] fiber pile
Fiber pile is a pile of nuclear system requirements for the ideal emerged . Our department since 2006, using fiber pile large area in dental defects, to good effect, the report is as follows.
1 Materials and Methods
1.1 General Information
Choose to outpatients tooth area defect cases 30 cases, including 8 males and 22 females; aged 20 to 40 years, a total of 40 teeth, front teeth 22, 18 posterior teeth. Case requirements: not loose teeth, gum disease, tooth neck at least 2mm health of the tooth structure (dentin shoulder collar), before the normal relationship of the posterior teeth bite together.
3MESPE RelyXFiberPost fiber root canal system, RrlyXUnicem universal self-adhesive resin cement, AdperPrompt Free etching adhesive, FilterZ250 Genesis before and after dental universal composite resin.
(1) root canal treatment: root canal treatment of teeth and root canal filling material to be temporarily closed to pay attention to choose the material does not contain eugenol. (2) post-core tooth preparation: the first crown or root surface preparation, removal of carious tissue and thin weak sharp, eliminate undercut retain tooth structure as much as possible, to keep at least 2mm dentin shoulder collar then utilize RelyXFiberPost fibrous root canal root canal preparation should choose the thickness according to the X-ray showed a root canal and to determine the appropriate type of fiber pile supporting bur root canal preparation. First primary preparatory drill to remove the 2/3 of the material, about the length of the root canal apical to retain the a 4mm closed area, and back with a fiber post and prepare the same type of drill to the desired length. Note prepared to maintain the stability of the fulcrum, prevent expand piles Road, to reduce the pile and the adhesion of the root canal wall, affect the stability of the early stages of the fiber pile, while paying attention to if the root canal coarser thicker drill bit should be used instead to ensure that completely remove the root filling material in the root canal wall. (3) The test pile: fiber post into the root canal of the same model selection and finalization of root canal preparation drill test pile, the pile are prepared to reach the depth of the root canal wall friction, and will be stretched out too long grinding in addition, pay attention to the grinding process to turn the pile, the pile fibers are evenly worn, do not use scissors to cut the fiber post, in order to avoid a pile of fiber dispersion. (4) piles of cement: After the test pile and cement ago, with an alcohol wipe the pile and rinse thoroughly disinfection of the root canal, in order to remove the smear layer on the root canal wall. Drying, moisture barrier, using RelyXUnicem generic self-adhesive resin cement, cement, cement when you want to avoid air bubbles injected cement prolonged head inserted into the root canal at the bottom of the cement into the root canal at the same time will be extended head slowly pull out the root canal, and the extension of the head – is always immersed in cement. Immediately place the root canal, gently rotate the appropriate pressure, get rid of the excess adhesive. Curing light 40s. (5) making resin core: Free with AdperPrompt processing pile and dentin surface etching adhesive, then use FilterZ250 Chong century or teeth universal composite resin on the heap resin core attention to the use of a small amount of plastic in order to reduce the polymerization of the resin contraction. To pay attention during the tight eliminate wet, in order to prevent contamination on the adhesive surface. (6) The crown of the tooth preparation: prepared in accordance with the porcelain crown tooth for tooth preparation, gingival retraction, take karyotype, the next steps with the conventional porcelain crown. (7) try them and cement porcelain crown: trying on porcelain crown, neck edge adhesion (with a probe across the crown margin smooth and not linked to the probe) according to the normal form of contact area, floss check tightness moderate, his teeth together, fit, both doctors and patients are satisfied with the color and shape of conventional cement.
The patients wearing teeth 1 year after referral, clinical examination combined with X-ray. In full compliance with the following criteria will be the successful. (1) teeth gums congestion, edema. (2) crown no loosening, no loss. (3) the pile without loosening, shedding. (4) no root fractures, root crack. (5) The crown color coordination with adjacent teeth, natural, and patient satisfaction. (6) X-ray showed apical original sparse areas is reduced or disappear. The six criteria as long as there is a reach that is failure. 30 cases, 40 teeth meet the above criteria, the success rate was 100%.
The modulus of elasticity of the root canal affect pile crown an important factor in the size of the tooth bending ability to repair fiber pile elastic touch 18 ~ 47GPa, with similar dentin 18GPa, good mechanical compatibility. Many studies suggest , the biggest advantage of the fiber pile is similar to the elastic touch volume and root dentin, thus the pile with the root form a homogeneous structure, in order to effectively pass occlusal force, to prevent piles and root dentin interface stress concentration caused root fracture. According to the finite element stress analysis, fiber pile stress concentration in the cervical Therefore, after the repair of tooth destruction formally fiber post restorations rootless fold or fold above the gingival margin, can repair again, and get better effect. The fiber pile stress concentration in the cervical, in select cases require repair tooth body and neck have a 2mm dentin shoulder collar to the neck of sufficient strength. Fiber piles using a resin-based adhesive cements and dentin, fiber pile have a good combination of properties, can increase the retention force, and the low solubility of the resin-based adhesive, can reduce the nuclear edge micro leakage. Also has a good combination of pre-pile after forming nuclear beautiful effect, clinical simple, you can reduce the number of referral of patients. And the fiber pile, and resin core is used in combination, so that the final prosthesis closer to the original structure of the natural tooth, their strength and elasticity are close to the dentin, and can be a resin-based adhesive, to achieve a strong and dentin between strong bonding, thereby forming an approximate homogeneity of structure, and the stress is distributed uniformly along the root, and to improve the flexural capacity of the repaired tooth. The fiber pile also has good biocompatibility, no cell toxicity . In addition, the fiber post with all-ceramic restorations, MRI non-magnetic interference. The fiber pile has many advantages, but in the root is too thick, the neck of the tooth remaining tooth structure (dentin shoulder collar), or still need to change the crown axial metal cast post and core is more appropriate. In addition, the short duration of fiber pile clinical applications, its long-term effect needs further study.
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