Composite resins to restore mutilated teeth

Operative dentistry

Composite

resins to restore

mutilated

teeth

Robert G. Spalten, D.D.S. San Antonio, Texas

I T he

recommendation that severely mutilated teeth be restored with pin-retained amalgam has become an accepted practice.‘. a These “built-up” teeth can then be prepared for a veneer restoration. This report suggests the use of a composite resin instead of silver amalgam for the restorative material. It seems only logical that .!f the tensile strength of amalgam is increased by pin retention,” the same would hold true for the composite resins. IPHYSICAL

PROPERTIES

OF COMPOSITES

‘The desirable physical properties of composites are (1) good marginal adaptation, (2) favorable pulpal response with a calcium hydroxide base, (3) lowsetting shrinkage, and (4) a small coefficient of thermal expansion.” According to Cotton and Leonard,j the composite filling materials they tested, even those without protective liners, caused minimal adverse pulpal response. Baume and Fiore-Donno reported that a calcium hydroxide liner provided almost complete protection against pulpal injuries using composite filling materials. TECHNIQUE After the caries has been excavated (Fig. 1) , insert self-threading pins where ;hey are needed. Self-threading pins are easy to insert and are the most retentive ~:ypr available.i, 8 Then apply the matrix (Fig. 2). Apply a calcium hydroxide :iner, and insert the composite resin into the matrix. The technique requires no condensation, and additions may be made to the primary mix if necessary. After !i minutes, remove the matrix, and prepare the tooth for the veneer restoration of choice (Fig. 3). Then the impression is made, and a temporary crown is placed. The entire procedure can be easily executed in one appointment. The final restoration may be seen in Fig. 4. ADVANTAGES The advantages of composites are as follows: (1) Composites manipulate; (2) their strength is comparable to the tooth structure,

are easy to and they are

-‘This JOIIRNAL

article

is being

OF PROSTHETIC

published DENTISTRY

simultaneously in the by special arrangement

Texas Dental journal between the editors.

and

THE

323

324

Spalten

J. Pro&. March.

Dent. 1971

Fig.

I

Fig.

Fig.

3

Fig.

Fig. Fig. Fig. Fig.

1. The tooth after excavating of the caries. 2. Self-threading pins and matrix are in place. 3. The tooth restored with composite resin and prepared 4. The completed restoration.

(3) they are almost as strong as amalgamQ; ases containing prepared at one sitting; (5) b (6) temporary acrylic crowns may be seated without affecting the composite resin; (7) placement, the composite resin will show a exists.

for

the impression.

fast setting; (4) composites can be zinc oxide and eugenol may be used; with zinc oxide and eugenol cement if the cast restoration binds during definite mark where the interference

POST CROWNS The same general idea can be used to construct a post crown (Figs. 5 to 8) . using a drill slightly larger than the selected stainless steel The canal is reamed post.* The post is cemented into place with zinc phosphate cement. One or more nonparallel

filled

with *Para-Post

self-threading

composite System,

pins

resin. The Whaledent,

are

inserted;

tooth Inc.,

then

the

is then prepared

Brooklyn,

N. Y.

matrix

band is appIied and

in the conventional

manner

4

Composite

Fig.

resins to restore mutilated

teeth

325

5

Fig.

6

7

Fig.

8

Fig.

5. The

existing

Fig.

6. The

pins

Fig.

7. The

Fig.

8. The

tooth

structure.

in place.

pin-retained porcelain

composite crown

cemented

resin

restoration

prepared

for

the impression.

in place.

at the same appointment. This technique will strengthen and splint the root much more easily than will the dowel and coping, and with less eff0rt.l This also simplifies shading problems for porcelain jacket crowns caused by lack of translucency. !iUMMARY

This technique has been used successfully in over 300 restorations, with few problems. It is not the purpose of this paper to advocate the use of composite resin restorations in place of amalgam. In this technique, the composite resin is covered with either gold, porcelain-on-gold, or porcelain crowns. All the teeth had bases placed in them which protected the pulpal tissue. As a result of the easy manipulation of composite resin, our “resurrection cases” are made much simpler and the results are satisfying. References 1~. Markley, M. R.: Pin Reinforcement tions, J. Amer. Dent. Ass. 56: 675-679,

and Retention 1958.

of Amalgam

Foundations

and

Restora-

326

Spalten

J. Prosth. Dent. March, 1971

2.

Markley, M. R.: Pin Retained and Pin Reinforced Amalgams, J. Amer. Dent. Ass. 73: 1295-1300, 1966. 3. Going, R. E., Moffa, J, P., Nostrant, G. W., and Johnson, B. E.: The Strength of Dental Amalgam as Influenced by Pins, J. Amer. Dent. Ass. 77: 1331-1334, 1968. 4. Sach, M. P.: Essay on Composite Resins, J. Connecticut Dent. Ass. 44: 8-13, 1970. 5. Cotton, W. R., and Leonard, E.: Pulpal Response in Rat Molars to a New Restorative Material Without a Liner, J. PROSTH. DENT. 18: 482-487, 1967. 6. Baume, L. J., and Fiore-Donno, G.: Response of the Human Pulp to a New Restorative Material, J. Amer. Dent. Ass. 76: 1016-1033, 1968. 7. Moffa, J., Razzano, M. R., and Doule, M. G.: Pins-a Comparison of Their Retentive Properties, J. Amer. Dent. Ass. 78: 529-535, 1969. 8. Dilts, W. E., Welk, D. A., and Stovall, J.: Retentive Properties of Pin Materials in PinRetained Silver Amalgam Restorations, J. Amer. Dent. Ass. 77: 1085-1089, 1968. 9. Lee, H. L., Jr., Swartz, M. L., and Smith, F. F.: Physical Properties of Four Thermosetting Restorative Resins, J. Dent. Res. 48: 526-535, 1969. 845 MILAM BLDG. SAN ANTONIO, TEXAS

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