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Restaurações indiretas estéticas adesivas posteriores: revisão de literatura narrativa
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Objetivo: Esta revisão de literatura teve como objetivo investigar qual a melhor estratégia na cimentação de restaurações indiretas posteriores, com principal ênfase nas técnicas Immediate dentin sealing (IDS) e Deep margin elevation (DME) e nos tipos de cimentos utilizados na cimentação adesiva, nomeadamente cimentos de resina convencionais e cimentos autoadesivos.
Metodologia: Foi realizada uma pesquisa através do motor de busca PubMed com as palavras chave adhesive cementation; indirect restorations; adhesive cements; immediate dentin sealing; deep margin elevation e proximal box elevation. A pesquisa e seleção dos artigos foi realizada desde setembro de 2019 até outubro de 2020 e foram incluídos 29 artigos.
Resultados: A técnica IDS resulta em valores de forças de adesão superiores quando comparada com a técnica DDS, quando utilizados sistemas adesivos etch-and-rinse. A DME é uma técnica promissora que permite facilitar o tratamento de cavidades extensas com as margens cervicais localizadas abaixo da margem gengival, no entanto é relativamente recente e a informação ainda é escassa pelo que são necessários mais estudos, principalmente estudos clínicos. Relativamente ao tipo de cimento, os cimentos convencionais com a utilização de sistemas adesivos etch-and-rinse promovem maiores forças de adesão e melhor integridade marginal.
Conclusão: O sucesso clínico e longevidade das restaurações indiretas é dependente de múltiplos fatores: materiais, técnicas utilizadas, fatores relacionados com o paciente e com o médico dentista. As técnicas de IDS e DME parecem ser técnicas promissoras.
Objectives: This literature review had as main objectives to investigate what is the best strategy for cementing indirect posterior restorations, with the main focus on the Immediate dentin sealing (IDS) and Deep margin elevation (DME) techniques and on the types of cements used for adhesive cementation, namely conventional resin cements and self-adhesive cements. Methods: A search was performed using the PubMed search engine with the keywords "adhesive cementation", "indirect restorations" "adhesive cements" "immediate dentin sealing" "deep margin elevation" and “proximal box elevation”. The search and selection of the articles was carried out from September 2019 to October 2020 and 29 articles were included. Results: The IDS technique results in higher bond strength values when compared to DDS technique, when using etch-and-rinse adhesive systems. DME is a promising technique that facilitates the treatment of extensive cavities with cervical margins located below the gingival margin. However, it is a relatively recent technique and information is still scarce. Further studies are needed, especially clinical studies. Regarding the type of cement, conventional cements using etch-and-rinse adhesive systems promote greater adhesion forces and better marginal integrity. Conclusion: According to the literature, the clinical success and longevity of indirect restorations is dependent on multiple factors related to the materials and techniques used, related to the patient and the clinician. IDS and DME seem to be viable techniques.
Objectives: This literature review had as main objectives to investigate what is the best strategy for cementing indirect posterior restorations, with the main focus on the Immediate dentin sealing (IDS) and Deep margin elevation (DME) techniques and on the types of cements used for adhesive cementation, namely conventional resin cements and self-adhesive cements. Methods: A search was performed using the PubMed search engine with the keywords "adhesive cementation", "indirect restorations" "adhesive cements" "immediate dentin sealing" "deep margin elevation" and “proximal box elevation”. The search and selection of the articles was carried out from September 2019 to October 2020 and 29 articles were included. Results: The IDS technique results in higher bond strength values when compared to DDS technique, when using etch-and-rinse adhesive systems. DME is a promising technique that facilitates the treatment of extensive cavities with cervical margins located below the gingival margin. However, it is a relatively recent technique and information is still scarce. Further studies are needed, especially clinical studies. Regarding the type of cement, conventional cements using etch-and-rinse adhesive systems promote greater adhesion forces and better marginal integrity. Conclusion: According to the literature, the clinical success and longevity of indirect restorations is dependent on multiple factors related to the materials and techniques used, related to the patient and the clinician. IDS and DME seem to be viable techniques.
Descrição
Tese de mestrado, Medicina Dentária, Universidade de Lisboa, Faculdade de Medicina Dentária, 2020
Palavras-chave
Saúde Oral Teses de mestrado - 2020