04-composite tieng viet [compatibility mode]

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Composite trong nha khoa

Composite trong nha khoa


Ni dung Lch s nh ngha Thut ng Cu trc ca Composite Phn loi Tnh cht quan trng ca Composite Tnh cht composite hin i Cch s dng Composite K thut trn composite ha trng hp


Lch s T nm 1940 nha

acrylic c s dng lm nn hm gi

Nha acrylic c trnh by di dng bt trn vi cht lng


n nm 1950, nha acrylic t cng (dnglm nn hm gi) c ci tin s dngtrong trm rng

Nha rt d s dng, bng v thm mban u tt

Vn chnh thng gp: s co rt cao khit trng hp + s thay i hnh dng khigp nhit cao + s i mu v mncao


Nm 1960, cc nh nghin cu v vt liutrm thm vo nha acrylic mt s cht hnh thnh nn Resin Composite (Composite nha khoa hoc Composite)


c trng cu to ca composite: c hai pha:- Pha t on (dispersed phase): ht n (filler),- Pha lin tc (pha bao bc, pha lin: continuous/matrix phase l mt pha lng trong qutrnh ch to composite): khung nha

Ngoi ra, cn c:- Cht ni: lin kt cc ht n vi khung nha- H thng hot ha v khi mo trng hp- Cht khc: cht to mu, cht n nh composite-

Thut ngThut ng


c trng cu to ca composite: c hai pha:- Pha t on (dispersed phase): ht n (filler),- Pha lin tc (pha bao bc, pha lin: continuous/matrix phase l mt pha lng trong qu trnh ch to composite ): khung nha

Ngoi ra, cn c:- Cht ni: lin kt cc ht n vi khung nha- H thng hot ha v khi mo trng hp- Cht khc: cht to mu, cht n nh composite-

Thut ngThut ng


Khung nha + Cht n

Bao bc ht n

Cau truc cua CompositeCau truc cua Composite

C ba thnh phn chnh trong cu trc Resin composite :


Cau truc cua CompositeCau truc cua Composite

Khung nha- Hu ht composite hin ang s dng ckhung nha da trnnghin cu ca R. Bowen (1962): tnghp oligomer Bis-GMA


- Bis-GMA l mt monomer chc nng kp to nn t phn ng gia Bis phenol A v Glycidyl methacrylate


- Trong cc composite hin nay, hai loi monomer khc c s dng:+ UDMA (UDM: Urethane dimethacrylate)+ TEGDMA (TEGDM: Triethylene Glycoldimethacrylate) c qunh thp, gip composite d s dng


Nhng yu cu i vi monomer/polymer ca composite:1. C tnh tng hp sinh hc (biocompatibility)2. C c im l hc tt ( bn nn, bn ko, bn mi mn....)3. Bn vng v ha hc trong mi trng ming4. n nh mu sc5. C hot tnh cao nhit thng6. Khng mi v


Ht n: Nhng ht hoc/v si c phn tn trong khung nha - Ht n quyt nh nhng c im quan trng ca Composite: cng, mn, tnh chu mi mn, co trng hp, cc c tnh quang hc- nh hng ca ht n i vi composite:

+ Thnh phn+ T l [mc / ln (kch thc]


Thnh phn ht n:- Silica nguyn cht tn ti di nhiu dng

+ Tinh th (crystal Balite Tridymite, hoc Quartz)

+ Khng tinh th (Glass).* Cc dng tinh th bn vng hn v cng hn nhng

lm cho composite kh lm nhn v nh bng hu ht composite ngy nay s dng silicate glass, cc

glass Ba, Zn, Y, thng c s dng nht lm cht n


- Ngoi silica, ht n thng c mt nhiu ion khc to nn nhng thay i tnh cht cnthit+ Li (Lithium), Al (Aluminum) lm cho Glass d dng nghin thnh cc ht nh.+ Ba (Barium), B (Boron) to tnh cnquang.+ Zn (Zinc) , Zr (Zirconium) v Y (Yttrium)...

Cng thng c mt- Cn c nhng thay i thm na (bng cch

thay th silicone trong cu trc)... tuy vy cth lm gim hiu qu ca cht ni.


Cht ni: dn ht n vo khung nga Trnh nc thm nhp vo mt tip xc ht n v khung nha Bn vng i vi s thy phn Dn truyn ngu lc co (stress) gia resin v ht n Ci thin c tnh composite Phn b u ht n trong resin


- Cht ni trong composite l mt khonghu c (silane): 3-Methacryloxy propyl-trimethoxy silane- Cht ni l phn t hai chc nng(bifunctional molecule), kt ni pha resin vpha ht n


Phn loi Theo kch thc ht n

- Kch thc ht n nh hng n tnhcht cc composite: Cc ht n cng hnkhung nha, do , khi lm nhn mt s htn c th bong khi b mt, li nhngl. Nu cc ht rt nh, b mt c lmnhn b nh hng khng ng k. B mtming trm g gh c th to s tn x vlu gi cc mnh vn hoc cht mu


- Composite c phn loi ty theo kchthc ht n nh sau : Cc ln (megafill) > 100 m Ln (macrofill) 10 - 100 m Trung bnh (midifill) 1 - 10 m Hi nh (minifill) 0,1 - 1 m Nh (microfill) 0,01 - 0,1 m Cc nh (nanofill) 0,005 - 0,01 m Composite lai l composite c ht hngm nhiu ln khc nhau. Tn cacomposite c gi theo tn composite cht n ln nht


Hnh 1. nh hng ca kch thc ht n trn b mt mingtrm sau khi hon tt A, Composite ht n trung bnh. B, Composite ht n nh (Ngun: Stephen C. Bayne, School of Dentistry, University of North Carolina, Chapel Hill, NC.)


Theo cch trng hp- Ha trng hp: c sn xut di dng hai l bt do, khi trn vi nhau s ng cng+ u im: khng cn n+ Khuyt im: Khng th ko di thi gian lm vic


Dng trnh by composite ha trng hp

CHT NN CHT XC TC


- Quang trng hp: s dng n, hin nay dng nh sng n halogen mu xanh. Khi chiu sng composite s ng cng+ u im: Ko di thi gian lm vic, thm m, tit kim cht trm, mau cng, gim xp+ c trnh by di dng ng hoc nhng


Dng trnh by composite quang trng hp


- Nhit trng hp: nha trng hp di tc ng ca nhit

- Composite s dng trong labo c th c x l bng cch s dng kt hp khc nhau ca nh sng, nhit , p sut v chn khng lm tng mc trng hp, mt , tnh cht c hc v chu ng s mi mn


Tm tt lch s pht trin ca composites nha khoa, phng php trng hp v h thng dn i km


Tnh cht quan trng ca Composite

S co khi trng hp- Khi cng, composite b co. Composite lai co t hn composite ht n nh- Khi soi mn men, ng, dng cht dn, lc co khi trng hp ln hn lc dn composite vo cu trc rng gy vi k, h b ming trm- Khc phc: gim s co khi trng hp:

+ Trm thnh nhiu lp composite+ Khng trm trc tip, thc hin inlay (trong labo), dn phc hi ln rng bng mt lp composite c nht thp


S dn nhit- Composite dn nhit thp hn nhiu so vi cc ti to c kim loi v ph hp vi men v ng- Composite gip cch nhit ty rng rt tt

S n nhit- Composite n nhit nhiu hn cu trc rng nn phc hi composite c s thay i kch thc theo nhit trong ming nhiu hn cu trc rng. Composite ht n nh c h s n nhit cao hn composite lai


S hp thu ncComposite ht n nh c nhiu kh nng b mt mu hn, do cc cht mu tan trong nc

S cn quang

bn nn v bn unComposite ht n nh c bn nn thp hn composite lai


Moun n hiMoun n hi ph thuc vo kch thc ht n v mc ht n c trong composite

cng v mnComposite lai khng hn vi s mn

bn dn bn dn composite vo men, ng ( xoi mn) gn ging nhau (14-30MPa) khi dng cht dn ton b


Tnh chat composite hien ai Ngu lc co t t tan trong nc H s gin n do nhit tng t cu trc rng Khng li lc gy v cao Chu c s mi mn Cn quang Bm dnh tt vo men v ng Thm m: Mu sc tng t vi cu trc rng D s dng D hon tt v d nh bng


Composite cho nhng ap dng c bit Composite lng

Sang thng c rng. Trm rng tr em. Nhng xoang nh c lc nhai thp.


Composite nhi (c) S dng cho xoang I, II, III v VI


Composite dng trong labo Mo, inlay, veneer c lm gin tip (trong

labo), kt hp nhiu yu t (nh sng, nhit , p sut, chn khng) tng s trng hp v khng mn

Tng cng si trong composite labo tng b v cng


Composite ti to ci rng Thng s dng amalgam ti to ci rng,

nhng hin nay composite ang dn thay th u im ca ci rng bng composite

+ Dn c vo ng.+ C th hon tt trong 1 bui lm vic+ To hnh d dng+ cng cao+ Mu thch hp bn di phc hi ton s


Composite cho phc hi tm Inlay tm, mo tm, cu tm c nhp di

thng c lm bng composite


K thut trn p dng cho composite ha trng hp

- Dng c: giy trn, bay trn bng nha- Cch trn:

+ Dng mt u bay trn ly mt lng bt do mt l

+ Dng u cn li ca bay trn ly lng bt do l cn li

+ Trn hai lng do bng nhau ha ln vo nhau+ Composite trn phi t mn, c v b mt

lng Thi gian trn: 20-30 giy Thi gian ng cng: 2 pht


u Khuyt im

u im- Thm m- Vi lu c hc vo cu trc men rng- Chun b rng ti thiu- Khi u: lu gi tt trn rng


Khuyt im- Mt nhiu thi gian thc hin tt k

thut trm- i vi rng trong: kh hon tt tt phn

b ming trm pha c rng, ti to hnhdng

- Nhy cm sau trm- Co ngt sau trm- Vi k, mn- t tin

u Khuyt im


Mau Composite So mu rng: chn mu composite ph hp

04-composite tieng viet [compatibility mode]

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