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Procedures
> CbC Technique
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Build strong, natural restorations from the inside out.Learn how to recreate nature by building restorations from the inside out, giving you greater durability for long-term performance. The CbC Technique, Compomer bonded Composite, helps you create a solid, natural restoration without gaps or voids. With a CbC restoration you'll also benefit from reduced post-operative sensitivity.
Two excellent new Sterngold materials join together in
the CbC Technique. With ideal flowability, OmegaFlo provides exceptional ease of use in reaching areas of difficult access. A light curing resin composite for anterior or posterior use, SternOmega LC offers the strength and esthetics required on occlusal or labial surfaces.
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CbC Technique
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One area of major interest related to esthetic dentistry has been the posterior composite resin. Introduced to the profession as a substitute for amalgam, it became apparent in a relatively short period of time that such a practice was not feasible. Abnormal rates of wear, microleakage, secondary caries and postoperative sensitivity soon became the trademarks of the posterior composite resin restoration.
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Flowable Composites
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Although this class of materials has been classified or described as flowable, a more appropriate name would be wettable because that is the primary purpose of the material. Rather than flowing , this low viscosity resin intimately wets the surface of the preparation. When compared to conventional composite resins, the flowable or wettable material wets and penetrates into considerably smaller surface substructures.
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OmegaFlo, unlike the flowable composite resins, is based upon the compomer concept. This is a low viscosity restorative material based upon a reactive ionomer glass and a polymerizable acid in a resin matrix. OmegaFlo bonds to moist dentin surfaces and exhibits a low modulus of elasticity. It is also characterized by excellent radiopacity (200%) and fluoride release.
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Using a flowable resin material has become mandatory for those who practice esthetic dentistry. OmegaFlo represents the latest development in this class of restorative systems. A combination of low elastic modulus, fluoride release and good resistance to wear makes it an excellent material for those who provide the highest level of clinical treatment.
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Technique
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First and most importantly, it is important to minimize the dimension of the cavity preparation as much as possible. Based upon considerable clinical research it has been demonstrated that, in general, the smaller the restoration, the greater the longevity. Since the retention of the restoration is by surface adhesion or bonding, extended preparations incorporating undercutting is not necessary. Unfortunately, the exact shape and dimension of the preparation cannot be determined by the operator. (figure 1)
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Figure 1
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For example, when replacing an existing amalgam, the opportunity for controlling size and dimension may not be possible. In such cases where an opposing cusp is very prominent or pointed, it is advisable to modify the shape of the cusp slightly.
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After acid etching and application of the dentin bonding agent, the preparation is matrixed.
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When the hybridization process has been completed, a thin layer of flowable compomer is injected onto the walls of the preparation. (figure 2)
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Figure 2
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The thickness of this material should be between 0.5 and 1.0 mm. It should cover the entire cavity preparation with the exception of the cavosurface margin. Such a process is vitally important to eliminate the potential of margin discrepancies.
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It is important at this point to light cure the flowable compomer for 15 to 20 seconds.
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Finally the composite resin is inserted into cavity, light cured and finished. (figure 3 & 4)
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The flowable compomer serves a number of functions. In addition to ensuring excellent marginal integrity, it acts as a buffer against the contraction forces of the overlaying composite resin during the curing process. This feature can be attributed to the fact that the elastic modulus of the intermediate material is about 50% of conventional or packable composite resins. Consequently, given a fixed amount of force, the flowable compomer liner will deform twice as much. This stress-breaking characteristic makes it an indispensable tool when using posterior composite resins.
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Omegaflo compomer possesses other properties that make it unique from other systems. Compared to the flowable composites, it cures at a lower initial rate. As a result, the prolonged setting behavior of the compomer causes less polymerization induced stress at the resin/dentin interface. Finally, since the compomer based liner tends to absorb minimal amounts of water, there is an associated amount of volumetric expansion. This gradually compensates for some of the contraction, which had occurred during the polymerization process. It also can potentially release some of the internal stresses produced as the resin based composites undergo polymerization.
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Learn the technique and communicate directly with Dr. Karl Leinfelder online. Ask questions, express concerns and the doctor will respond with solutions.
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