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Facetas cerâmicas: avaliação da influência de diferentes sistemas de cimentação adesiva
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As facetas cerâmicas são consideradas restaurações indiretas previsíveis, estéticas e conservadoras com excelente desempenho clínico. A adesão à superfície dentária é promovida pela utilização de sistemas adesivos e cimentos resinosos, formando um complexo de adesão constituído pela superfície dentária, cerâmica e pelo cimento resinoso. O grande objetivo das restaurações adesivas está em alcançar um íntimo contacto entre os materiais restauradores e os tecidos dentários. Para tal, foram desenvolvidos sistemas adesivos que promovem uma interação entre estas duas superfícies. A adesão à estrutura dentária é maioritariamente micromecânica, contudo é possível promover uma adesão química pela adição de monómeros específicos, nos sistemas adesivos, com afinidade para a hidroxiapatite. Atualmente existem vários tipos de estratégias adesivas, com base num sistema total-etch ou self-etch. Os cimentos resinosos são utilizados com o objetivo de aderir restaurações indiretas à estrutura dentária, de forma estável e a longo-prazo. Estes estão indicados na cimentação das facetas cerâmicas devido à capacidade de adesão à estrutura dentária e cerâmica e às propriedades mecânicas e óticas superiores. Podem ser divididos em foto, auto-polimerizáveis ou com dupla-polimerização. A adesão do cimento à superfície interna da cerâmica é micromecânica – promovida pelo condicionamento com ácido hidrofluorídrico – e química – promovida pelo silano. Apesar das facetas cerâmicas serem consideradas como o tratamento de eleição em medicina dentária estética, existem algumas controvérsias quanto ao tipo de tratamento da superfície dentária e cerâmica e tipos de cimentos que se devem utilizar. Em geral, os cimentos apresentam bons resultados na adesão quer para estrutura dentária, quer para a superfície cerâmica, quando o correto condicionamento e tratamento destas superfícies é realizado. Uma vez que a adesão ao esmalte tem provado ser superior à dentina, recomenda-se que a preparação para facetas cerâmicas seja o mais conservadora possível, limitando a preparação do dente ao esmalte.
Ceramic veneers are considered predictable, aesthetic and conservative indirect restorations with excellent clinical performance. Adhesion to the tooth surface is promoted by the use of adhesive systems and resin cements, forming an adhesion complex made up of the tooth surface, ceramic and the resin cement. The ultimate goal of adhesive restorations is to achieve an intimate contact between restorative materials and dental tissues. To this end, adhesive systems have been developed to promote interaction between these two surfaces. Adherence to tooth structure is mostly micromechanics, however it is possible to promote chemical adhesion by adding specific monomers in adhesive systems, with affinity for hydroxyapatite. Currently there are various types of adhesive strategies, based on a total-etch or self-etch system. The resin cements are used in order to attach indirect restorations to tooth structure, in a stable and long-term manner. These are indicated in the cementation of ceramic veneers due to adhesiveness to tooth and ceramic structure and due to better mechanical and optical properties. They can be divided into photo, self or dual-cure. The adhesion of the cement to the inner surface of the ceramic is micromechanics - promoted by etching with hydrofluoric acid – and chemical - promoted by the silane. Despite ceramic veneers are considered the treatment of choice in aesthetic dental medicine, there are some controversies about the type of treatment of dental and ceramic surfaces and types of cements that should be used. In general, the cement shows good results in adhesion to both tooth structure, or to the ceramic surface, when the correct conditioning and treatment of these surfaces is performed. Since the adhesion to enamel has proven to be superior to dentin, it is recommended that the preparation for ceramic veneers to be the most conservative possible, limiting the preparation of the tooth enamel.
Ceramic veneers are considered predictable, aesthetic and conservative indirect restorations with excellent clinical performance. Adhesion to the tooth surface is promoted by the use of adhesive systems and resin cements, forming an adhesion complex made up of the tooth surface, ceramic and the resin cement. The ultimate goal of adhesive restorations is to achieve an intimate contact between restorative materials and dental tissues. To this end, adhesive systems have been developed to promote interaction between these two surfaces. Adherence to tooth structure is mostly micromechanics, however it is possible to promote chemical adhesion by adding specific monomers in adhesive systems, with affinity for hydroxyapatite. Currently there are various types of adhesive strategies, based on a total-etch or self-etch system. The resin cements are used in order to attach indirect restorations to tooth structure, in a stable and long-term manner. These are indicated in the cementation of ceramic veneers due to adhesiveness to tooth and ceramic structure and due to better mechanical and optical properties. They can be divided into photo, self or dual-cure. The adhesion of the cement to the inner surface of the ceramic is micromechanics - promoted by etching with hydrofluoric acid – and chemical - promoted by the silane. Despite ceramic veneers are considered the treatment of choice in aesthetic dental medicine, there are some controversies about the type of treatment of dental and ceramic surfaces and types of cements that should be used. In general, the cement shows good results in adhesion to both tooth structure, or to the ceramic surface, when the correct conditioning and treatment of these surfaces is performed. Since the adhesion to enamel has proven to be superior to dentin, it is recommended that the preparation for ceramic veneers to be the most conservative possible, limiting the preparation of the tooth enamel.
Descrição
Tese de mestrado, Medicina Dentária, Universidade de Lisboa, Faculdade de Medicina Dentária, 2016
Palavras-chave
Materiais dentários Adesivos dentários Teses de mestrado - 2016